鼻息肉患者外周血Th17／Treg细胞比率的失衡及其临床意义

Imbalance of Th17/Treg cell ratio in peripheral blood of patients with nasal polyposis and its clinical significance

目的:观察鼻息肉(NP)患者外周血Th17和Foxp3+CD4+CD25+调节性T细胞(Treg)的水平及其与临床病情的关系,初步探讨Th17/Treg细胞的比率失衡在NP发病机制中的作用和意义。方法:NP患者根据鼻内镜和鼻窦CT评分的结果分为1组(鼻内镜检查评分:2～8分;CT检查评分:3～10分,n=23)和2组(鼻内镜检查评分:8～12分;CT检查评分:10～19分,n=23),选取10例单纯鼻中隔偏曲患者作为对照组。采用流式细胞术检测外周血中Th17和Treg的比例,并对Th17/Treg的比率及鼻内镜、鼻窦CT评分进行相关性分析。结果:两组NP患者外周血中Th17细胞比率明显高于对照组(P<0.01),且2组高于1组(P<0.05)。两组NP患者外周血中Treg细胞的比率明显低于对照组(P<0.01),但两组间差异无统计学意义。两组NP患者Th17/Treg细胞的比率明显高于对照组(P<0.01),且两组间差异显著(P<0.05)。同时,相关性分析结果显示,Th17/Treg细胞的比率与鼻内镜、鼻窦CT评分呈正相关(r=0.562,r=0.667,P<0.01)。结论:NP患者外周血中Th17细胞比率增加和Treg细胞比率降低所致的Th17/Treg细胞比率失衡,可能在NP的发生发展中起着重要作用。Th17/Treg比率失衡的程度可能与临床病情严重程度密切相关。

AIM： To observe the distribution of Th17 cells and Foxp3^＋ CD4^＋ CD25^＋ regulatory T cells in peripheral blood of patients with nasal polyposis（NP） and their correlation with clinical patients＇ condition, and to explore the role of Th17/Treg cell ratio imbalance in pathogenesis of nasal polyposis and significance. METHODS： The frequencies of Th17 cells and Treg cells were determined in 46 patients with NP and 10 controls by flow cytometry. The 46 patients were divided into two groups according to endoscopy score and CT score： the 1 group （endoscopy score： 2-8 scores; CT score： 3 - 10 scores, n = ：23 ） and the 2 group （endoscopy score： 8 - 12 scores; CT score： 10 - 19 scores, n = 23）. RESULTS： Th17 cells were significantly higher in the blood of patients with NP compared with the control group （ P 〈 0.01）, and the percentage was higher in the 2 group than the ] group （ P 〈 0.05）. The frequency of Treg cells was significantly decreased in patients with NP compared to the control group （ P 〈 0.01 ）, whereas the difference between two groups was not significant. The ratio of Th17/Treg cells was highest in the 2 group （ P 〈 0. 01 ）, lower in the ] group （ P 〈 0. 0l ） and lowest in control subjects, and the differences were also significant between two groups （ P 〈 0.05）. Furthermore, it was confirmed that the ratio of Th17/Treg positively correlated with endoscopy score and CT score （ P 〈 0.01 ）. CONCLUSION： The imbalance of Th17/Treg cell ratio characterized by increased Th17 cells and decreased Treg cells exists in peripheral blood of NP patients and may play an important role in the onset and development of NP. The degree of Th17/Treg cell imbalance may associate with clinical presentation.