IL-10^+B细胞对儿童过敏性紫癜Th17/Treg免疫平衡紊乱的影响

Effects of IL-10^+B cells on Th17/Treg imbalance in Henoch-Sch?nlein purpura

目的探讨IL-10^+B细胞(B10)水平及功能异常可能通过影响Th17/Treg的免疫平衡,参与过敏性紫癜(HenochSch(o|¨)nlein purpura,HSP)的发生发展。方法选取HSP患儿和健康体检儿童共58例,HSP患儿根据肾脏累及情况分为3组:无肾脏累及组15例(A组)、纯血尿组12例(B组)、蛋白尿组15例(C组);另设正常对照组16例。采用流式细胞术检测患儿外周血中Th17细胞、Treg细胞、CD19^+CD24^(hi)CD38^(hi)B细胞和CD19^+CD24^(hi)CD27^+B细胞的百分比,以及B10细胞及其亚类(CD19^+CD24^(hi)CD38^(hi)B细胞和CD19^+CD24^(hi)CD27^+B细胞)的IL-10的表达水平。结果与对照组相比,B、C组中Th17细胞的比例和Th17/Treg的比值逐渐升高2,Treg细胞和CD19^+CD24^(hi)CD38^(hi)B细胞的比例以及总的B10细胞、CD19^+CD24^(hi)CD38^(hi)B细胞和CD19^+CD24^(hi)CD27^+B细胞分泌IL-10的水平逐渐降低,且均有统计学差异(P<0.05);而CD19^+CD24^(hi)CD27^+B细胞只在C组中显著降低(P<0.05);HSP患儿B10细胞、CD19^+CD24^(hi)CD38^(hi)B细胞和CD19^+CD24^(hi)CD24^(hi)B细胞与Th17细胞以及Th17/Treg的比值呈显著负相关(P<0.05),B10细胞和CD19^+CD24^(hi)CD38^(hi)B细胞与Treg细胞呈显著正相关(P<0.05)。结论 B10细胞参与HSP的发生发展可能与其分泌IL-10的能力降低,从而对Th17/Treg免疫平衡的调节障碍有关。且相较于CD19^+CD24^(hi)CD27^+B细胞,CD19^+CD24^(hi)CD38^(hi)B细胞亚群可能是预测HSP发生发展以及肾脏累及严重程度的相对敏感指标。

This study aimed to investigate the effect of IL-10＋ B cells （B10） on the imbalance of Th17/Treg in children with Henoch-Schtinlein purpura （HSP）. Total of 58 cases of HSP and healthy children were selected and divided into 4 groups as follows： 15 HSP children without renal involvement （group A）, 12 HSPN children with only microhematuria （group B）; 15 HSPN children with proteinuria （group C）, while 16 healthy children were selected as normal control group （Control）. Flow cytometry was employed to detect the percentages of Thl7 cells, Treg cells, CD19 ＋ CD24hiCD38hiB cells, CD19＋ CD24hiCD27 ＋B cells and the expression of IL-10 by B10 cells, CD19＋ CD24hiCD38hiB cells and CD19＋CD24hiCD27＋B cells. Data showed that in groups B and C, Thl7 ceils and the Thl7/ Treg ratio were increasingly increased （P〈0.05）, but Treg cells, CD19＋CD24hiCD38hIB cells and the expression of IL-10 by B10 ceils, CD19＋CD24hiCD38hiB ceils and CD19＋CD24hiCD27＋B cells were increasingly decreased （P〈 0.05）, whereas, the percentages of CD19＋CD24hiCD27＋B cells were decreased only in group C （P〈0.05）, comparing to those in control group. However, Th17 cells, Treg cells, Thl7/Treg ratio, CD19＋ CD24hiCD38hhiB cells, CD19 ＋ CD24hiCD27＋B cells and the expression of IL-10 by B10 cells, CD19 ＋ CD24hiCD38hiB cells and CD19＋ CD24hiCD27＋B ceils showed no significant difference in group A versus control group. Moreover, B10 cells, CD19＋CD24hiCD38hiB cells and CD19＋CD24hiCD27＋B cells were all negatively correlated with Thl7 ceils or Thl7/Treg ratio. B10 cells and CD19＋ CD24hiCD38hiB cells were both positively correlated with Treg cells. In conclusion, B10 cells may play an important role in the development of HSP through affecting the balance of Thl7/Treg by reducing IL-10 expression. It is CD19＋CD24hiCD38hiB cells but not CD19＋CD24hiCD27＋B cells that may be a relative sensible indicator for predicting the occurrence of HSP and the clinical severity of renal involvement.