儿童变应性鼻炎Th17/Treg表达与中医证型及病情的相关性研究

Correlation Analysis of Th17/Treg Expression and TCM Syndromes and Severity of Allergic Rhinitis in Children

目的探讨不同中医证型变应性鼻炎(AR)患儿Th17/Treg及其细胞因子的表达特点,并分析Th17/Treg细胞失衡与儿童AR症状评分的相关性。方法130例AR患儿根据中医证型分为肺气虚寒组(50例)、脾气虚弱组(32例)、肾阳不足组(21例)和肺经伏热组(27例),30例健康儿童为对照组。检测各组外周血Th17、Treg细胞水平和IL-17、TNF-α、IL-10、TGF-β表达水平。并分析不同中医证型患儿Th17/Treg比值与AR症状评分的相关性。结果Th17细胞水平和IL-17、TNF-α水平在肺经伏热证患儿中表达最高,肺气虚寒证和脾气虚弱证次之,肾阳不足证最低。肺气虚寒证和脾气虚弱证Treg细胞水平和IL-10、TGF-β水平低于肺经伏热证和肾阳不足证。肺气虚寒证和脾气虚弱证患儿Th17/Treg比值最高,肺经伏热证次之,肾阳不足证最低。各中医证型患儿Th17/Treg比值均与AR症状评分呈正相关(P<0.05)。结论Th17/Treg细胞及其细胞因子在儿童AR不同中医证型间存在表达差异,可为儿童AR的中医辨证治疗提供客观依据。Th17/Treg细胞失衡程度与各证型患儿病情严重程度均呈正相关。

Objective To investigate the expression characteristics of Th17,Treg and related cytokines in children with allergic rhinitis(AR)with different traditional Chinese medicine(TCM)syndromes,and the correlation between Th17/Treg imbalance and severity of allergic rhinitis in children was analyzed.Methods A total of 130 children with AR were divided into deficiency cold of lung qi group(50 cases),spleen qi deficiency group(32 cases),kidney yang deficiency group(21 cases),hidden heat in lung group(27 cases)according to TCM syndromes,and 30 healthy children in the same period were selected as control group.The levels of Th17 and Treg cells in peripheral blood was detected by flow cytometry,and the expression levels of IL-17,TNF-α,IL-10 and TGF-βwere detected by enzyme-linked immunosorbent assay.The correlation between Th17/Treg ratio and AR symptom score in different TCM syndromes was analyzed by pearson correlation.Results The levels of Th17 and IL-17,TNF-αof hidden heat in lung group were higher than the other three TCM syndrome groups,those of deficiency cold of lung qi group and spleen qi deficiency group were higher than those of kidney yang deficiency group.The levels of Treg and IL-10,TGF-βof deficiency cold of lung qi group and spleen qi deficiency group were lower than those of kidney yang deficiency group and hidden heat in lung group.The Th17/Treg ratio of deficiency cold of lung qi group and spleen qi deficiency group was higher than that of kidney yang deficiency group and hidden heat in lung group.The Th17/Treg ratio of hidden heat in lung group was higher than that of kidney yang deficiency group.Th17/Treg ratio was positively correlated with AR symptom score(P<0.05).Conclusions The expression of Th17/Treg cells and related cytokines is different among different TCM syndromes of children with AR,which can provide objective basis for TCM syndrome differentiation and treatment of children with AR.In addition,the imbalance degree of Th17/Treg is positively correlated with the severity of AR in children with different syndrome types.