川崎病急性期患者Th17细胞检测及意义

Significance of the alteration of Th17 cells in the acute phase of Kawasaki disease

目的:探讨川崎病患者急性期Th17细胞的水平及意义。方法:急性期川崎病(KD)患儿43例,正常同年龄对照41例,采用流式细胞术检测外周血单个核细胞(PBMC)中Th17细胞占CD4+细胞的比例。荧光定量PCR(Real-time-PCR)检测RORγt和IL-23p19mRNA的表达。双抗体夹心酶联免疫吸附法(ELISA)检测血清IL-6水平。结果:急性期KD患儿外周血Th17细胞比例及其特异性转录因子RORγt的mRNA表达分别为:(1.285±0.625)%、(M:5.62,Q:7.16),显著高于同龄对照组(0.584±0.407)%、(M:1.79,Q:2.55),(P<0.01)。KD患儿血清IL-6水平显著增高[病人:(M:36.42,Q:129.77)、对照:(M:2.39,Q:1.15)](P<0.01),且与Th17细胞比例成正相关(r=0.88,P<0.01)。IL-23p19的mRNA表达与正常对照比较无显著差异[病人:(M:2.12,Q:3.05)、对照:(M:1.73,Q:2.79)](P>0.05)。结论:急性期川崎病患者Th17细胞数量、血清IL-6水平升高;Th17可能作为急性炎症的启动因素,参与川崎病免疫发病过程。

Objective：To investigate the alteration and significance of Th17 in the acute phase of Kawasaki disease（KD）.Methods：Forty-three children with Kawasaki disease in the acute phase and forty-one age-matched healthy children were studied.The proportion of Th17 cells/CD4＋ in peripheral blood mononuclear cells（PBMCs） was analyzed with flow cytometry.Real-time PCR was performed to evaluate the mRNA expression of retinoid-related orphan receptor γt（RORγt） and interleukin-23p19（IL-23p19） in peripheral blood.The level of plasma IL-6 was assayed by enzyme-linked immunosorbent assay（ELISA）.Results：The proportion of Th17 and expression of RORγt mRNA from patients with KD in the acute phase were（1.285±0.625）% and（M：5.62,Q：7.16）,respectively,which were significantly increased as compared with the controls[（0.584±0.407）% and（M：1.79,Q：2.55）,respectively]（P〈0.01）.The level of IL-6 in patients with KD（M：36.42,Q：129.77） was markedly higher than that in age-matched healthy children（M：2.39,Q：1.15）（P〈0.01）.Furthermore,positive correlation was observed between the level of IL-6 and proportion of Th17（r=0.88,P〈0.01）.However,no significant difference was found in the expression of IL-23p19 mRNA between patients and healthy children.Conclusion：Th17 cells and it＇s related cytokine IL-6 increases in the acute phase of KD,which may be involved in immunological pathogenesis of KD.