辅助性T22细胞和辅助性T17细胞在重度子痫前期发病中的作用

Role of T helper 22 and 17 cells in pathogenesis of severe preeclampsia

目的探讨辅助性T（Thelper，Th）22细胞及Th17细胞的相关性及其在重度子痫前期发病中的作用。方法选择2014年10月至2016年2月在郑州大学第三附属医院住院并分娩的重度子痫前期孕妇30例为重度子痫前期组，按1：1比例选择同期孕周和年龄与重度子痫前期组相匹配的产前检查正常的健康孕妇30例为健康孕妇组。采用流式细胞技术检测2组孕妇外周血中Th22细胞和Th17细胞占CD4＋T淋巴细胞的百分比，采用酶联免疫吸附试验检测血浆中白细胞介素（interleukin，IL）-22和IL-17A的浓度。采用两独立样本t检验、非参数检验及Spearman相关分析探讨组间Th22细胞和Th17细胞数量及血浆IL-22和IL-17A的浓度差异及其相关性。结果重度子痫前期孕妇外周血中Th22细胞占CD4＋T淋巴细胞百分比为0．59％（0．39％～1．13％），高于健康孕妇[0．40％（O．23％～0．57％）]，Th17细胞占CD4＋T淋巴细胞百分比也高于健康孕妇[3．24％（3．02％～3．97％）与1．87％（1．53％～2．64％）]，差异均有统计学意义（Z值分别为2．530和5．046，P值分别为0．010和0．000）。重度子痫前期孕妇血浆中IL-22的浓度明显高于健康孕妇，分别为285．72（247．63～306．69）与233．85（184．92～258．38）pg／ml，差异有统计学意义（Z=3．341，P=0．001）；重度子痫前期孕妇血浆中IL—17A的浓度也高于健康孕妇，分别为27，53（23．8±32．78）与17．36（15．58～19．13）pg／ml，差异有统计学意义（Z=4．924，P=0．000）。在重度子痫前期孕妇中，Th17细胞数量与Th22细胞数量正相关性（r=0．534，P=0．015）；而在健康孕妇中，未见明显相关性（r=0．345，P=0．136）。重度子痫前期孕妇血浆中IL-22浓度与Th22细胞数量正相关（r=0．600，P=0．005），而与Th17细胞数量未见明显相关性（r=0．398，P=0．082）。结论重度子痫前期孕妇外周血中Th22细胞的数量及其细胞因子IL-22的浓度的增加可能是母体的一种代偿性保护机制；子痫前期孕妇Th22细胞与Th17细胞的分化可能彼此相互影响。

Objective To investigate the role ofT helper （Th） 22 and Th17 cells in the pathogenesis of severe preeclampsia. Methods Thirty women with severe preeclampsia who delivered in the Third Affiliated Hospital of Zhengzhou University from October 2014 to February 2016 were enrolled in the study. Thirty healthy pregnant women matched for age and gestational weeks were recruited as the control group. The frequencies of Th22 and Th17 cells in peripheral whole blood were determined by flow cytometry. The concentrations of interleukin （IL）-22 and IL-17A in plasma were detected by enzyme-linked immunosorbent assay. Independent two samples t test, non-parametric test and Spearman correlation analysis were used for statistical analysis. Results The percentage of Th22 and Thl7 cells in the severe preeclampsia group were significantly higher than those in the control group, respectively[Th22 cells： 0.59% （0.39%-1.13%） vs 0.40% （0.23%-0.57%）, Z=2.530, P=0.010; Th17 cells： 3.24% （3.02%-3.97%） vs 1.87% （1,53%-2.64%）, Z=5.046, P=0.000]. So were the plasma levels of IL-22 and IL-17A[IL-22：285.72 （247.63-306.69） vs 233.85 （184.92- 258.38） pg/ml, Z=4.341, P=0.001; IL-17A： 27.53 （23.84-32.78） vs 17.36 （15.58-19.13） pg/ml, Z=4.924, P=0.000]. There was a positive correlation between circulating Th22 and Th17 cells in the severe preeclampsia group （r=0.534, P=0.015）, while no correlation was found in the control group （r=0.345, P=0.136）. Positive correlation was found in plasma level of IL-22 with Th22 cells （r=0.600, P=0.005）, but not with Thl7 cells （r=0.398, P=0.082） in the severe preeclampsia group. Conclusions Increased Th22 cells and high IL-22 concentrations in the peripheral blood of severe preeclampsia patients may indicate a self-defense mechanism in the maternal body, Th22 cells and Th 17 cells may interact with each other.