Th17和Treg细胞及相关细胞因子在手足口病患儿外周血中的变化

Alterations of Treg cells, Th17 cells and some related cytokines in peripheral blood of patients with hand-foot-mouth disease

目的：研究手足口病患儿感染初期外周血中Th17与调节性T细胞（Treg细胞）及相关细胞因子的水平变化。方法采用流式细胞术检测75名手足口病患儿（分为重症病例组和普通病例组）和30例正常儿童外周血中（CD3＋CD8-IL-17＋）Th17及（CD4＋CD25＋Foxp3＋）Treg细胞的变化，采用ELISA方法检测血清中IL-6、IL-10、IL-17、IL-23、TGF-β1的水平。结果手足口病患儿各组与正常对照组相比，Treg细胞百分率、Treg/Th17比率及TGF-β1、IL-10水平均明显降低（F＝5．580、6．205、0．000、0．014，P均＜0．05），重症病例组中Th17细胞百分率明显升高（F＝3．189，P＜0．05），IL-17有增高趋势，但差异不大，各组IL-23差异也无统计学意义（P＞0．05）；重症病例组IL-6的含量与普通病例组、正常对照组相比明显升高（F＝7．318，P＜0．05）。结论手足口病患儿感染初期外周血Treg/Th17细胞及相关细胞因子的水平出现变化，通过减少Treg细胞，增加Th17细胞，扩大炎症反应，促进抗病毒作用。

Objective To investigate the alterations of Treg cells , Th17 cells and related cyto-kines in peripheral blood of patients during the early stage of hand-foot-mouth disease （ HFMD） .Methods Flow cytometry was performed to analyze the percentages of Treg cells （ CD4＋CD25＋Foxp3 T cells） and Th17 cells （ CD3＋CD8-IL-17＋T cells） in peripheral blood samples collected from 49 patients with severe HFMD , 26 patients with common HFMD and 30 healthy children.The levels of IL-6, IL-10, IL-17, IL-23 and TGF-β1 in serum samples were measured by ELISA .Results The percentages of Treg cells , ratios of Treg/Th17 cells, serum levels of TGF-β1 and IL-10 in patients with HFMD were significantly decreased as compared with those of control group （F=5.580, 6.205, 0.000, 0.014, respectively, P〈0.05）.Patients with se-vere HFMD showed a significantly increased Th17 cells （F=3.189 P〈0.05） and a tendency of enhanced IL-17 expression , but no significant differences with the levels of IL-17 were observed .No significant differ-ences with the expression of IL-23 in the patients among each group were detected （P〉0.05）.The levels of IL-6 in serum samples from severe disease group were obviously increased as compared with those of common HFMD group and control group （F=7.318, P〈0.05）.Conclusion The results of this study demonstrated that the levels of Treg , Th17 cells and some related cytokines were varied in peripheral blood of patients dur-ing the early stage of HFMD .Inflammatory responses were enhanced to promote anti-virus activities by sup-pressing Treg cells and stimulating Th17 cells.