基于Th17/Treg阴阳消长平衡的清热益气通窍法干预CRS黏膜重塑的研究

慢性鼻—鼻窦炎（CRS）是耳鼻喉科常见难治病。鼻窦黏膜重塑在CRS炎症迁延及难治性方面有重要意义。Th17与Treg间构成了符合阴阳对立统一性的消长平衡体系。Th17/Treg平衡失常是CRS黏膜重塑的重要原因。在前期科学基金研究中，我们发现清热益气通窍治疗能够改善CRS鼻窦黏膜重塑，惜未阐明机制，甚憾。但部分研究结果显示：清热益气通窍治疗能够抑制IL-17这一由Th17分泌的细胞因子表达，促进CHIP这一参与Treg调节的E3泛素连接酶表达。故推测：清热益气通窍法改善CRS鼻窦黏膜重塑的机制，可能与其影响Th17及Treg分化和功能的关键信号网络，恢复Th17/Treg的消长平衡有关。因此，本研究拟应用分子生物学等研究手段，观察清热益气通窍法对CRS模型鼻窦黏膜Th17/Treg平衡及相关分化和功能调控网络的影响，从Th17/Treg间阴阳消长平衡角度，阐明该法改善CRS黏膜重塑的机制。

As the common refractory disease in otolaryngological department, chronic rhinosinusitis（CRS）has strong impacts on patients. Mucosa tissue remodeling has close associations with refractoriness and discontented outcome of CRS. Both pro-inflammatory Th17 and anti-inflammatory Treg, two respects of unity of opposites, constitute dynamic equilibrium system. Th17/Treg imbalance would lead to mucosa remodeling in CRS. We showed that clear away Heat and supplement Qi method to relieve stuffy nose has ability of ameliorating mucosa remodeling of CRS in earlier researches, but had no chance to illuminate the concrete mechanism due to limitations of research direction and funds. It is implied that clear away Heat and supplement Qi method to relieve stuffy nose could down-regulate expression of cytokine IL-17 secreted by Th17 but up-regulate expression of E3 Ubiquitin Ligase CHIP related to Treg regulation. We speculate that clear away Heat and supplement Qi method to relieve stuffy nose may have impacts on the key to differentiation and function of Th17/Treg , not only to restore equilibrium of Th17/Treg but also ease mucosa remodeling. It is worth to expound how such therapeutic method ameliorates mucosa remodeling in CRS from the perspective in Th17/Treg balance. Hence,we plan to adopt histopathological and molecular biological analysis to observe the effects of this therapeutic method on the equilibrium, differentiation and function of Th17/Treg.