Интерлейкин 23 у больных системными васкулитами, ассоциированными с антинейтрофильными цитоплазматическими антителами: собственные результаты и обзор литературы

В патогенезе системных васкулитов, ассоциированных с антинейтрофильными цитоплазматическими антителами (АНЦА-СВ), могут участвовать клеточные реакции, опосредованные Т-хелперами 17-го типа (Th17). Мы изучали зависимость клинических параметров от содержания в сыворотке крови больных АНЦА-СВ интерлейкина 23 (ИЛ23), принимающего участие в реализации Th17-ответа, а также влияние терапии на этот показатель.

Цель – исследовать концентрацию ИЛ23 в сыворотке крови больных АНЦА-СВ с различной активностью заболевания и разным индукционным лечением в сравнении со здоровыми донорами.

Материал и методы. При помощи иммуноферментного анализа (ИФА) исследована концентрация ИЛ23 у 40 больных АНЦА-СВ [медиана возраста – 44 года (от 20 до 65 лет); соотношение женщины/мужчины – 1,11] и 8 здоровых доноров [медиана возраста 47 лет (от 21 года до 66 лет); соотношение женщины/мужчины – 1,67]. У 23 пациентов АНЦА-СВ был классифицирован как гранулематоз с полиангиитом, у 14 – как микроскопический полиангиит и у 3 – как эозинофильный гранулематоз с полиангиитом. В активную стадию АНЦА-СВ были обследованы 26 больных, в период ремиссии – 28 (у 22 из 28 ремиссия была индуцирована ритуксимабом). Проанализирована связь между концентрацией ИЛ23 и активностью заболевания, особенностями клинического течения АНЦА-СВ.

Результаты и обсуждение. Статистически достоверное повышение концентрации сывороточного ИЛ23 в сравнении со здоровыми донорами отмечено только у больных с дебютом АНЦА-СВ, не получавших лечения (медиана 41,9 и 13,1 пг/мл соответственно; p<0,05). Применение как иммуносупрессивной, так и анти -В-клеточной терапии стойко снижало сывороточную концентрацию ИЛ23 (до 5,2–8,8 пг/мл).

Заключение. Перспективно дальнейшее изучение ИЛ23 и функционально близких ему цитокинов при АНЦА-СВ.

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