花粉症患者在季节发作期外周血Th17/Treg细胞的平衡变化及其临床意义

Dynamic changes in Th17/Treg balance among children with seasonal allergic rhinitis

目的 探讨花粉症患者在发作期和非发作期外周血Th17/调节性T细胞（Treg）平衡变化及其临床意义.方法 纳入13例花粉症患者、10例尘螨过敏哮喘患者以及10例健康儿童,分别在发作期和非发作期采用流式细胞术检测外周血Th17/Treg平衡变化,ELISA检测血清中IL-17、IL-10和TGF-β水平.结果 （1）在发作期内,花粉症组外周血Th17细胞[（3.4±2.4）%]显著高于尘螨过敏哮喘组[（2.1±1.6）%]、健康对照组[（0.5±0.3）%]（P均〈0.05）;花粉症组[（2.1±1.3）%]、尘螨过敏哮喘组[（3.6±1.9）%]外周血Treg细胞水平均显著低于健康对照组[（5.5±2.8）%],差异具有统计学意义（P均〈0.05）.在非发作期,花粉症组患者外周血Th17细胞[（3.0±1.9）% vs （3.4±2.4）%,P〈0.05]、Th17/Treg比例[（1.4±1.0）% vs （1.7±1.5）%, P〈0.05]均降低,而Treg水平升高[（2.4±1.6）% vs （2.1±1.3）%,P〈0.05].未观察到尘螨过敏哮喘组患者在非发作期外周血Th17细胞、Treg以及Th17/Treg比例发生变化. （2）相关性分析：发作期内花粉症组外周血Th17/Treg比例与呼出气一氧化氮（FeNO）水平（r=0.321,P〈0.05）、外周血嗜酸性粒细胞计数存在正相关关系（r=0.198,P〈0.05）.结论 花粉症患者在发作期内存在Th17/Treg免疫失衡的病理状态,这可能是导致其临床症状急性发作的重要机制之一.

Objective To investigate the levels and significance of Th17 cells and regulatory T cells （Treg） in peripheral blood of children with allergic rhinitis during pollen and non-pollen seasons.Methods Thirteen children with hay fever, 10 children with house dust mite（HDM）-allergic asthma and 10 healthy children were recruited into this study.Percentages of Th17 and Treg cells were detected by flow cytometry.Levels of IL-17, IL-10 and TGF-β in cell culture supernatants were measured by ELISA.Results （1） The percentages of Th17 cells in children with allergic rhinitis [（3.4±2.4）%] were significantly higher than those in HDM-allergic asthmatics [（2.1±1.6）%] and those in healthy children [（0.5±0.3）%] during pollen season （both P〈0.05）.The levels of Treg cells in allergic rhinitis group [（2.1±1.3）%] and in HDM-allergic asthma group [（3.6±1.9）%] were significantly lower than those in healthy control group [（5.5±2.8）%] （both P〈0.05）.The levels of Th17 cells [（3.0±1.9）% vs （3.4±2.4）%, P〈0.05] and ratios of Th17/Treg cells [（1.4±1.0）% vs （1.7±1.5）%, P〈0.05] in children with allergic rhinitis were significantly decreased during non-pollen season as compared with those during pollen season, but the levels of Treg cells were up-regulated [（2.4±1.6）% vs （2.1±1.3）%, P〈0.05].（2） Correlation analysis revealed that the ratios of Th17/Treg cells were positively correlated with the concentrations of FeNO （fractional concentration of exhaled NO） （r=0.321, P〈0.05） and the counts of circulating eosinophils （r=0.198, P〈0.05） in children with allergic rhinitis during pollen season.Conclusion The imbalanced Th17 and Treg cells in children with allergic rhinitis during pollen season might play a vital role in the regulation of allergic airway inflammation.