儿童过敏性紫癜急性期Th17细胞功能和CD4^+CD25^+调节性T细胞水平变化

FUNCTION OF Th17 CELLS AND CHANGES OF CD4^+CD25^+T REGULATORY CELLS IN CHILDREN WITH HENOCH-SCHONLEIN PURPURA IN ACUTE PHASE

目的观察过敏性紫癜(HSP)病儿急性期Th17细胞功能和CD4+CD25+调节性T细胞(CD4+CD25+Treg)水平变化,探讨其在HSP免疫发病机制中的作用。方法选择54例HSP急性期病儿为研究对象,根据尿检有无异常分为肾炎组(HSPN组)和非肾炎组(NHSPN组),应用酶联免疫吸附试验(ELISA)方法检测血浆白细胞介素17(IL-17)水平,采用流式细胞术检测外周血CD4+CD25+Treg、CD4+细胞、CD8+细胞、CD3+细胞、NK细胞(CD3-CD56+)、B淋巴细胞(CD19+)和CD3+HLADR+细胞水平。以30名健康儿童作为对照。结果HSP病儿血浆IL-17水平较对照组明显增高(t=14.66,P<0.01),HSPN组和NHSPN组间比较差异无统计学意义(P>0.05)。HSP病儿外周血CD4+CD25+Treg比例明显低于对照组(t=7.28,P<0.01),HSPN组和NHSPN组间比较差异无统计学意义(P>0.05)。HSP病儿CD4+CD25+Treg水平与CD4+细胞呈正相关(r=0.554,P<0.01),与CD19+细胞呈负相关(r=-0.305,P<0.05),而与CD8+细胞、CD3+细胞、CD3-CD56+细胞以及CD3+HLADR+细胞则无相关性(r=-0.109～0.287,P>0.05)。HSP病儿血浆IL-17水平与CD4+CD25+Treg水平呈负相关(r=-0.295,P<0.05)。结论 HSP病儿急性期Th17细胞功能增强,免疫抑制效应不足;HSP病儿存在Th17/Treg平衡紊乱,Th17/Treg失衡参与了HSP的发病过程。

Objective To investigate the function of Th17 cells and changes of CD4＋CD25＋ T regulatory（Treg） cells in children with Henoch-Schonlein purpura（HSP） in acute phase and explore their roles in immunopathogenesis of the disease.Methods Fifty-four patients with HSP were involved in this study,and randomized to HSP-Nephritis（HSPN） group and non-HSPN（NHSPN） group based on a urine analysis.The plasma interleukin-17（IL-17） was measured by ELISA,and CD4＋CD25＋Treg cells,CD4＋cells,CD8＋ cells,CD3＋ cells,NK cells（CD3-CD56＋）,B cells（CD19＋） and CD3＋HLADR＋ cells were detected by flow cytometric analysis.Thirty healthy kids were served as controls.Results The plasma level of IL-17 in the sick kids was higher than that in the control（t=14.66,P0.01）,while that the difference between HSPN and NHSPN groups was not significant（P0.05）.The ratio of CD4＋CD25＋Treg cells in peripheral blood of the patients was lower than that of the control（t=7.28,P0.01）,the difference of that between the HSPN and NHSPN was not significant（P0.05）.The level of CD4＋CD25＋ Treg cells in the sick children was positively correlated with CD4＋ cells（r=0.554,P0.01）,negatively correlated with CD19＋ cells（r=-0.305,P0.05）,but not correlated with CD8＋,CD3＋,CD3-CD56＋ and CD3＋HLADR＋ cells（r=-0.109-0.287,P0.05）.Plasma level of IL-17 in the sick children was negatively correlated with CD4＋CD25＋Treg cells（r=-0.295,P0.05）.Conclusion The function of Th17 cells is enhanced and immunosuppression insufficient in patients with HSP,the imbalance of Th17/Treg involves in the process of HSP development.