重度子痫前期患者外周血Th17和Treg细胞变化及意义

The imbalance of Th17 and Treg cells in patients with severe pre-eclampsia

目的探讨重度子痫前期(s PE)患者外周血Th17及CD4^+CD25^+Treg细胞变化及意义。方法选取2011-2013年镇江妇幼保健院40例s PE患者及40名健康对照者。采用流式细胞术检测外周血单个核细胞中Th17及CD4^+CD25^+Treg细胞水平;采用ELISA检测血浆IL-17、IL-22、TGF-β和IL-10水平,并分析其与s PE的相关性。结果 s PE患者组外周血Th17细胞水平为(1.21±0.82)%,显著高于健康对照组的(0.74±0.63)%,差异有统计学意义(t=3.45,P=0.002)。s PE患者组外周血CD4^+CD25^+Treg细胞水平为(1.65±0.49)%,显著低于健康对照组的(2.42±0.91)%,差异有统计学意义(t=-4.25,P=0.001)。s PE患者组IL-17、IL-22水平分别为80.03±31.25、60.22±18.32ng/L,高于健康对照组的32.84±17.23、35.24±14.33ng/L,差异有统计学意义(t值分别为10.74、5.89,P均<0.01),IL-10、TGF-β水平为26.29±10.31、25.65±11.81ng/L,低于健康对照组的33.24±11.93、48.261±13.85ng/L,差异有统计学意义(t值分别为3.35、6.78,P均<0.01)。s PE患者血浆IL-17、IL-22水平与Th17细胞水平呈显著正相关(r=0.69、0.58,P<0.01)。结论 s PE患者Th17细胞数量增高,CD4^+CD25^+Treg细胞数量减少,以及相关细胞因子的紊乱在s PE的发病机制中可能起到重要作用。

Objective To analyze the levels of Th17 and CD4-＋CD（25）-＋Treg cells in peripheral blood of patients with s PE. Methods The percentage of Th17 and CD4-＋CD（25）-＋Treg cells in peripheral blood were examined by flow cytometry. Plasma cytokines levels were measured by ELISA. Results The percentage of Th17 cells in patients with s PE was higher than that of healthy controls [（1.21±0.82）% vs（0.74±0.63）%,t=3.447,P=0.002]. The percentage of CD4-＋CD（25）-＋Treg cells in patients with s PE was lower than that of healthy controls [（1.65±0.49）% vs（2.42±0.91）%,t=-4.25,P=0.001]. Plasma levels of IL-17,IL-22 in s PE patients were 80.03±31.25、60.22±18.32ng/L,and in the control group were 32.84±17.23、35.24±14.33ng/L,respectively,they were significantly different between the two groups（t=10.74、5.89,all P0.01）. However,IL-10 and TGF-β levels were markedly decreased in s PE patients compared with controls（26.29 ±10.31、25.65±11.81ng/L vs 33.24 ±11.93、48.261 ±13.85ng/L,t =-3.35、6.78,all P 0.01）. IL-17、IL-21 had positive correlation with Th17 cells（r =0.69、0.58,respectively,all P 0.01） in s PE patients. Conclusion This study suggests that the imbalance of Th17 cells and CD4-＋CD（25）-＋Treg cells,the disorder of related cytokines are important in the pathogenesis of s PE.