新型冠状病毒感染患者血清TH1、TH2和TH17相关细胞因子水平：Meta分析

The Level of Serum TH1, TH2 and TH17-Related Cytokines in Patients with COVID-19 Infection: A Meta-Analysis

摘要: 目的：本研究采用Meta分析方法，系统评估了COVID‐19患者外周血中TH1、TH2、TH17相关细胞因子水平，并深入探讨了这些细胞因子研究结果存在差异的原因。方法：本研究已通过国际荟萃分析INPLASY平台认证(INPLASY协议认证编号：202380023)，通过检索中国知网、PubMed、Embase、Cochrane和Web of Science数据库，收集COVID-19患者和健康对照群体外周血TH1、TH2、TH17相关细胞因子(TNF-a、IL-2、IL-4、IL-10、IL-17)水平的病例对照研究，检索时间范围为建库至2023年10月10日。由研究者独立完成文献筛选、数据提取和偏倚评估，使用RevMan 5.4软件进行Meta分析。结果：该Meta分析共检索出19,941项研究，最终纳入了6项进行Meta分析，这些研究均为中、高质量文献。患者入组的时间范围从2020年~2022年不等。结果表明：COVID-19感染组的患者外周血TNF-a水平显著高于健康对照组(HC组) [MD = 3.42, 95%CI (1.91, 4.92), I² = 50%, P < 0.00001]；COVID-19感染组患者外周血IL-4水平显著高于健康对照组(HC组) [MD = 2.21, 95%CI (0.99, 3.42), I² = 98%, P = 0.0004]；COVID-19感染组患者外周血IL-10水平显著高于健康对照组(HC组) [MD = 3.38, 95%CI (1.97, 4.80), I² = 84%, P < 0.00001]；COVID-19感染组患者外周血IL-17水平显著高于健康对照组(HC组) [MD = 5.94, 95%CI (1.50, 10.39), I² = 98%, P = 0.009]；COVID-19感染组患者与HC组外周血IL-2水平差异无统计学意义[MD = 0.89, 95%CI (−2.19, 3.97), I² = 67%, P = 0.57]。结论：一些与TH1、TH2及TH17相关的细胞因子在COVID-19患者外周血中的水平明显高于健康对照组，这些细胞因子在新型冠状病毒感染的疾病进展中起着重要作用。

Abstract: Objective: In this study, we used Meta-analysis to systematically evaluate the levels of TH1, TH2, and TH17-related cytokines in the peripheral blood of COVID-19 patients, and the reasons for the differences in the findings of these cytokines were explored in depth. Methods: This study has been validated by the international Meta-analysis INPLASY platform (INPLASY protocol certification number: 202380023), by searching China Knowledge, PubMed, Embase, Cochrane and Web of Science databases, a case-control study on the levels of TH1, TH2, and TH17-related cytokines (TNFa, IL-2, IL-4, IL-10, and IL-17) in peripheral blood of COVID-19 patients and healthy control groups was collected, with a search timeframe from library construction to October 10, 2023. Literature screening, data extraction and bias assessment were done independently by the authors, and Meta-analysis was performed using RevMan 5.4 software. Results: The Meta-analysis retrieved a total of 19,941 studies, and 6 were finally included for Meta-analysis, which were all medium- and high-quality literature. The time of patient enrollment ranged from 2020 to 2022. The results showed that patients in the COVID-19-infected group had significantly higher peripheral blood TNF-a levels than in the healthy control group (HC group) [MD = 3.42, 95%CI (1.91, 4.92), I² = 50%, P < 0.00001]; peripheral blood IL-4 levels were significantly higher in patients in the COVID-19-infected group than in the healthy control group (HC group) [MD = 2.21, 95%CI (0.99, 3.42), I² = 98%, P = 0.0004]; peripheral blood IL-10 levels were significantly higher in patients in the COVID-19-infected group than in the healthy control group (HC group) [MD = 3.38, 95%CI (1.97, 4.80), I² = 84%, P <0.00001]; peripheral blood IL-17 levels were significantly higher in patients in the COVID-19-infected group than in the healthy control group (HC group) [MD = 5.94, 95%CI (1.50, 10.39), I² = 98%, P = 0.009]; the difference in peripheral blood IL-2 levels between patients in the COVID-19-infected group and the HC group was not statistically significant [MD = 0.89, 95%CI (−2.19, 3.97), I² =67%, P = 0.57]. Conclusion: Some cytokines related to TH1, TH2 and TH17 were significantly higher in the peripheral blood of COVID-19 patients than in the healthy control group, and these cytokines play an important role in the disease progression of novel coronavirus infections.