2019 年第 4 期 第 14 卷

FIZZ1和白细胞介素4及γ-干扰素在弥漫性间质性肺疾病中的表达及对患者临床转归的影响

Expressions of found in inflammatory zone 1, interleukin-4 and γ-interferon in diffuse interstitial lung disease and the effect on clinical outcomes

作者：廖洋江宇罗春程胜

英文作者：

单位：401331重庆医科大学附属大学城医院呼吸中心

英文单位：

关键词：弥漫性间质性肺疾病；FIZZ1；白细胞介素4；γ-干扰素；临床转归

英文关键词：

• 摘要：

• 【摘要】目的    探讨FIZZ1、白细胞介素4（IL-4）、γ-干扰素在弥漫性间质性肺疾病（DILD）中的表达及对患者临床转归的影响。方法    前瞻性选取2011年1—12月于重庆医科大学附属大学城医院首次确诊为DILD的患者37例，分别于治疗前、治疗3个月后检测患者肺组织中FIZZ1蛋白、FIZZ1 mRNA及肺泡灌洗液中白细胞介素4（IL-4）和γ-干扰素的表达情况，并根据患者的疾病转归将其分为治疗有效组和治疗无效组。结果    治疗3个月后27例有效（治疗有效组），10例无效（治疗无效组）。治疗后，治疗有效组肺组织中FIZZ1蛋白、FIZZ1 mRNA和肺泡灌洗液中IL-4水平明显低于治疗无效组［（0.49±0.12）比（0.71±0.18）、（0.68±0.19）比（0.92±0.23）、（45±8）ng/L比（105±9）ng/L］，γ-干扰素水平明显高于治疗无效组［（28±5）ng/L比（15±3）ng/L］（均P＜0.05）。治疗前患者FIZZ1蛋白、FIZZ1 mRNA与IL-4均呈正相关（r=0.637，P＜0.001； r=0.624，P＜0.001），与γ-干扰素均呈负相关（r=-0.529，P＜0.001； r=-0.511，P＜0.001）。结论    FIZZ1、IL-4、γ-干扰素在DILD中均有表达，且彼此存在相互作用。不同疾病转归患者的3种因子表达水平存在差异，通过探索有效方法抑制或调控其表达，将有效抑制早期肺纤维化形成，阻止肺功能减退，提高患者生活质量，同时为疾病转归、预后监测提供新的生物学标志物。

• 【Abstract】Objective    To explore the expressions of found in inflammatory zone 1(FIZZ1), interleukin-4(IL-4) and γ-interferon(γ-IFN) in diffuse interstitial lung disease（DILD） and the effect on clinical outcomes. Methods    A total of 37 patients diagnosed of DILD in University-Town Hospital of Chongqing Medical University from January to December 2011 were prospectively enrolled. Expressions of FIZZ1 protein and FIZZ1 mRNA in lung tissue, expressions of IL-4 and γ-IFN in bronchoalveolar lavage fluid were detected before and 3 months after treatment. The patients were divided into effective group and ineffective group according to the clinical outcomes. Results    All patients were followed up for 3 months; 27 cases were improved(effective group) and 10 cases were ineffective(ineffective group). After treatment, expression levels of FIZZ1 protein, FIZZ1 mRNA and IL-4 in the effective group were significantly lower than those in the ineffective group［（0.49±0.12） vs （0.71±0.18）, （0.68±0.19） vs （0.92±0.23）, （45±8）ng/L vs （105±9）ng/L］; expression level of γ-IFN in the effective group was significantly higher than that in the ineffective group［（28±5）ng/L vs （15±3）ng/L］(P＜0.05). Before treatment, FIZZ1 protein and mRNA expressions were positively correlated with IL-4 level（r=0.637， P＜0.001； r=0.624， P＜0.001） and they were negatively correlated with γ-IFN level（r=-0.529， P＜0.001； r=-0.511， P＜0.001）. Conclusions    There an interaction among expressions of FIZZ1, IL-4 and γ-IFN in patients with DILD and the expression levels are associated with clinical outcomes. Down-regulation of FIZZ1, IL-4, γ-IFN can inhibit early pulmonary fibrosis, restrain pulmonary dysfunction, improve quality of life; these factors may be new biomarkers for prognostic prediction of DILD.