Treg与Th17细胞在桥本氏甲状腺炎发病机制中的作用

The effect of Treg and Th17 cells in Hashimoto's thyroiditis patients with normal thyroid function

目的探讨Treg与Th17细胞在桥本氏甲状脉炎(HT)发病机制中的作用。方法选取甲功正常的桥本氏甲状腺炎患者45例(HT组),包括用L-T4将甲功维持在正常范围的22例(治疗组)和初诊的甲功正常的桥本氏甲状腺炎患者23例(初发组),同时纳入27例健康人设为正常对照组。采集受试者静脉血5ml,并用流式细胞技术检测各组外周血单个核细胞(PBMC)中Treg、Th17细胞数及其比例。结果 HT组外周血单个核细胞(PBMC)中Treg细胞数、Treg/Th17比值明显低于正常对照组(P<0.05),Th17细胞数高于正常对照组,但差异无统计学意义(P>0.05);初发组TPOAb和TgAb抗体滴度虽高于治疗组,但差异无统计学意义(P>0.05);Treg、Th17细胞数及Treg/Th17比值在治疗组和初发组之间差异无统计学意义(P>0.05);TPOAb、TgAb滴度与Treg、Th17细胞数及Treg/Th17比值无明显相关性(P>0.05)。结论 Treg、Th17细胞功能失衡在HT发病中起重要作用,甲状腺功能异常可能会影响Treg、Th17细胞功能。L-T4替代治疗可能会降低HT患者TPOAb、TgAb滴度,但其作用机制尚需进一步研究。

Objective To explore the role of Treg and Th17 cells in the pathogenic mechanism of HT.Method HT patients with normal thyroid function（n=45）were were divided into untreated group（23 subjects not taking L-T4）and treated group（22 subjects taking L-T4）.Twenty-seven healthy individuals were recruited as control group.Flow cytometry was performed to detect the percentages of Treg and Th17 cells in each group.Results HT group had lower Treg and Treg/Th17 than control group（all P〈0.05）,but there was no significant difference of Th17 between HT and control group（p=0.115）.Untreated group had much higher TPOAb and TgAb titer than treated group,but no significant difference was found（all P〉0.05）.There were no significant differences of Treg,Th17 between treated and untreated group.Treated group had higher Treg/Th17 ratio than untreated group,but the difference was no significant.In HT group,there were no correlations between TPOAb,TgAb titer and Treg,Th17 and Treg/Th17 ratio.Conclusion Treg and Th17 cells should be involved in the pathogenesis of HT and thyroid function might influent Treg and Th17 cells.L-T4 could lower titer of TPOAb and TGAb,but more studies should be carried out to illuminate the menchanism.