肠道病毒性脑炎患儿外周血辅助性T细胞17／调节性T细胞平衡及相关免疫细胞因子水平改变的临床研究

Clinical study of peripheral blood helper T cell 17/regulatory T cell balance and levels of related immune cytokines in children with enterovirus encephalitis

目的研究肠道病毒性脑炎患儿外周血辅助性T细胞17（Th17）／调节性T细胞（Treg）平衡及相关免疫细胞因子水平改变。方法选取2014年1月至2017年1月102例肠道病毒性脑炎患儿纳入肠道病毒性脑炎组，选取同期门诊体检的100例健康儿童为健康对照组。采用流式细胞术检测受检儿童外周血Th17和Treg表达，计算Th17／Treg；采用酶联免疫吸附试验检测血清白细胞介素（IL）-6、IL-17、IL-23、IL-4、IL-10、转化生长因子（TGF）．B水平。结果肠道病毒性脑炎组外周血Th17和Th17／Treg显著高于健康对照组（0．032±0．006比0．024±0．004和3．04±0．61比1．99±0．37），外周血Treg显著低于健康对照组（0．011±0．002比0．013±0．002），差异有统计学意义（P〈0．05）。肠道病毒性脑炎组血清IL-6、IL-17、IL-23显著高于健康对照组，血清IL．4、IL．10、TGF．B显著低于健康对照组，差异有统计学意义（P〈0．05）。结论Th17在肠道病毒性脑炎患儿外周血中呈高表达，Treg呈低表达，存在Thl7／Treg失衡现象。IL-6、IL-17、IL-23、IL-4、TT-1nTCF-β等Th17和Treg相关免疫细胞因子可能参与肠道病毒性脑炎发生。

Objective To study the peripheral blood helper T cell 17 （Thl7）/regulatory T cell （Treg） balance and levels of related immune eytokines in children with enterovirus encephalitis. Methods One hundred and two children with enterovirus encephalitis from January 2014 to January 2017 were selected as enterovirus encephalitis group, and 100 healthy children who received physical examination during the same period were selected as healthy control group. The peripheral blood expressions of Thl7 and Treg were detected by flow cytometry, and the Th17/Treg was calculated. The serum levels of interleukin （IL） -6, IL-17, IL-23, IL-4, IL-10 and transforming growth factor （TGF） -β were detected by enzyme-linked immunosorbent assay. Results The peripheral blood expression of Th17 and Th17/Treg in enterovirus encephalitis group were significantly higher than those in healthy control group （0.032± 0.006 vs. 0.024 ± 0.004 and 3.04±0.61 vs. 1.99±0.37）, the peripheral blood expression of Treg was significantly lower than that in healthy control group （0.011 ＋ 0.002 vs. 0.013 ± 0.002）, and there were statistical differences （P 〈 0.05）. The serum levels of IL-6, IL-17 and IL-23 in enterovirus encephalitis group were significantly higher than those in healthy control group, the serum levels of IL-4, IL-10 and TGF-β were significantly lower than those in healthy control group, and there were statistical differences （P 〈 0.05）. Conclusions The peripheral blood expression of Thl7 is high, and the peripheral blood expression of Treg is low in children with enterovirus encephalitis. There is imbalance of Thl7/Treg. The IL- 17, IL-23, IL-4, IL-4, IL- 10, TGF-β and other Th17 and Treg related immune cytokines may be involved in the pathogenesis of enterovirus encephalitis.