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目的：通过检测白细胞介素23 受体（IL-23R）及白细胞介素17A（IL-17A）在炎症性肠病（IBD）患者肠黏膜及血清中的表达水平，探讨其在IBD发病过程中的作用及意义。方法：收集32 例克罗恩病（CD）患者、29 例溃疡性结肠炎（UC）患者及27 例对照者的内镜肠黏膜活检标本，采用荧光定量PCR技术检测肠黏膜内IL-23R、IL-17A mRNA的表达情况，免疫组化技术分析IL-23R、 IL-17A在肠黏膜中的原位表达。结果：与健康对照组相比，CD 及UC 患者肠黏膜组织内IL-23R mRNA 表达显著增高（P<0.05）， CD及UC组间的表达量差异无统计学意义（P>0.05）。CD及UC患者肠黏膜组织内IL-17A mRNA表达显著增高（P<0.05），CD组肠黏膜组织内IL-17A mRNA表达显著高于UC组（P<0.05）。免疫组化分析显示IL-23R阳性细胞在CD与UC肠黏膜固有层内有较多表达，较正常黏膜内的肠上皮细胞相比，CD及UC患者肠黏膜IL-23R 蛋白表达量最著增高（P<0.05），UC 及CD 组间的表达量差异无统计学意义（P>0.05）。IL-17A阳性细胞在CD与UC肠黏膜固有层内有较多表达，较正常黏膜内的肠上皮细胞相比，CD 及UC 患者肠黏膜IL-17A 蛋白表达量最著增高（P<0.05）。结论：IL-23R 及IL-17A 在IBD 患者肠黏膜中表达显著增高，提示 IL-23R及IL-17A表达异常与IBD的发生发展密切相关，有可能成为IBD治疗的新靶点。

英文摘要:

Objective: To investigate the function and significance of interleukin-23 receptor (IL-23R) and interleukin-17a (IL-17A) in the pathogenesis of inflammatory bowel disease (IBD) by detecting the expression in the intestinal mucosal of patients with IBD. Methods: Intestinal or colonic mucosal biopsies of 32 patients with Crohn's disease (CD), 29 patients with ulcerative colitis (UC) and 27 healthy controls were chosen. The expression of IL-23R and IL-17A was detected by real-time PCR and the situ expression of IL-23R and IL-17A in intestinal mucosa was analyzed with immunohistoehemistry. Results: Compared with that in healthy controls, the expression of IL-23R at mRNA level in inflamed mucosa of CD and UC patients increased significantly (P<0.05), and there was no statistic difference between CD and UC groups (P>0.05); The expression of IL-17A at mRNA level in inflamed mucosa of CD and UC patients increased significantly (P<0.05), and there was the statistic difference between CD and UC groups (P<0.05). The immunohistochemistry results indicated that more IL-23R and IL-17A positive cells were in the intestinal or colonic mucosa of UC and CD patient, and the expression of IL-23R and IL-17A in normal lamina mucosa was low. The expression of IL-23R and IL-17A protein in the intestinal or colonic mucosa of CD and UC patients increased significantly (P<0.05). Conclusion: The expression of IL-23R and IL-17A in the intestinal mucosa of IBD patients increased significantly，which suggested that abnormal IL-23R and IL-17A expression may had closely relation with the pathogenesis of IBD. IL-23R and IL-17A may be a new target for the IBD treatment.

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