后循环短暂脑缺血发作患者外周血Treg、IL-17检测及意义

Changes of CD4^+ CD25^+ regulatory T cells and interleukin-17 in patients with posterior circulation transient ischemic attack and their clinical significances

目的探讨后循环短暂缺血发作(TIA)患者外周血CD4+CD25+调节性T细胞(Treg)比例、白介素17(IL-17)的水平变化及意义。方法 2012年9月至2013年2月纳入后循环TIA患者65例,根据ADCD2评分分为高危组(4～7分,34例)和低危组(0～3分,31例),另取同期本院体检中心健康成人30例作为对照组。采用流式细胞分析法及酶联免疫吸附法检测各组外周血Treg占CD4+T细胞比例及血清IL-17浓度值。结果高危组外周血Treg与CD4+细胞比值(11.38±3.58)%显著低于低危组[(14.83±4.10)%,P<0.05]和对照组[(15.60±4.19)%,P<0.05],低危组和对照组没有统计学差异(P>0.05)。高危组血清IL-17浓度[(312.65±63.69)pg/ml]和低危组[(290.13±63.65)pg/ml,P<0.05]显著高于对照组[(207.26±63.00)pg/ml,P<0.05],而高危组和低危组之间无统计学差异(P>0.05)。结论高危后循环TIA患者外周血Treg减少、IL-17浓度升高,可能是导致其外周血自身免疫调节失去平衡,进而发生脑梗死的原因之一。

Objective To explore the changes of CD4＋ CD25＋ regulatory T cells （Treg） and interleukin-17 （IL-17） in the peripheral blood of patients with posterior circulation transient ischemic attack （PC-TIA） and their clinical siguificances. Methods Sixty-five patients with PC-TIA were prospectively recruited from September, 2012 to February, 2013. According to ABCD2 score, 34 were assigned to high-risk group （with 4~7 point of ABCD2 score） and 31 to low-risk group （with 0~3 point of ABCD2 score）. Another 30 health adults were recruited as control group. The ratio of Treg to CD4＋ T cells （Treg/CD4＋） in the peripheral blood was detected by flow cytometry and the level of IL-17 in peripheral blood was detected by enzyme linked immunosorbent assay. Results The ratio of Treg/ CD4＋ was significantly lower in high-risk group （11.38%_＋3.58%） than those in low-risk group （14.83%_＋4.10%; P〈0.05） and control group （15.60%_＋4.19%; P〈0.05）, but there were no significant difference between low-risk group and control group （~〉0.05）. The concentration of IL-17 was significantly higher in high-risk group （312.65_＋63.69 pg/ml） and low-risk group （290.13_＋63.65 pg/ml） than that in control group （207.26_＋63.00 pg/ml; P〈0.05）, but there were no significant difference between low-risk group and high-risk group （P〉0.05）. Conclusions The ratio of Treg/CD4＋ decreases and the concentration of IL-17 increases in the peripheral blood of the patients with PC-TIA with high risk for stroke. These results suggest that Treg and IL-17 might be involved in the pathogenesis of the posterior circulation stroke.