血清MK和Th17/调节性T细胞对类风湿关节炎患者病情发生发展的影响

Effect of serum MK and Th17 and regulatory T cell on the occurrence and development of patients with rheumatoid arthritis

目的观察辅助性T细胞17(Th17)/调节性T细胞(Terg)免疫失衡在来风湿关节炎患者发病时的作用,探讨血清中期因子(MK)和Th17/调节性T细胞对类风湿关节炎患者病情发生发展的影响。方法选取2013年3月~2016年1月在我院接受治疗的类风湿关节炎患者58例,分为活动组和非活动组,DAS28≤3.2为非活动组,DAS28>3.2为活动组,另将30例健康患者作为对照组,活动组患者32例,非活动组患者26例,采用酶联免疫吸附法对3组患者的血清MK、白介素-17(IL-17)、白介素-6(IL-6)、白介素-23(IL-23)水平进行检测,利用流式细胞术检测调节性T细胞和外周血Th17细胞的比例变化,并对其比例变化和血清MK、IL-17、IL-6、IL-23的水平进行比较。结果活动组Th17、调节性T细胞比例分别与非活动组相比较差异具有统计学意义(P<0.05),活动组与非活动组的Th17、调节性T细胞比例分别与对照组相比较异具有统计学意义(P<0.05)。活动组与非活动组的IL-17、IL-6和IL-23水平分别与对照组相比较异具有统计学意义(P<0.05)。血清MK与Th17、T细胞的百分比和平衡相关的相关性结果显示,Th17和Treg均与血清MK无关,P>0.05,而与STAT5成负相关(P<0.05)。结论类风湿性关节炎患者的血清MK上升,且类风湿性关节炎患者Th17/Terg平衡中Th17相对增高,而Terg会相对降低,MK的上升和Th17/Terg平衡失调都促进了RA的发生发展。

Objective To explore the effect of immune imbalance of T helper cell17(Th17)and regulatory Tcell(Terg)on attack of patients with rheumatoid arthritis and to explore the effect of serum midkine(MK),Th17andregulatory T cell on the occurrence and development of patients with rheumatoid arthritis.Methods58patients withrheumatoid arthritis who were admitted to our hospital from March2013to January2016were selected.They were dividedinto the active group(DAS28>3.2)and the inactive group(DAS28≤3.2).Other30healthy people were selected as thecontrol group.There were32cases in the active group and26cases in the inactive group.Levels of serum MK,Interleukin-17(IL-17),Interleukin-6(IL-6)and Interleukin-23(IL-23)were detected by enzyme linked immunosorbent assay.Changesof ratio of regulatory T cell and peripheral blood(Th17)were detected by flow cytometry.In addition,changes of ratio andlevels of MK,IL-17,IL-6and IL-23were compared.Results Th17and regulatory T cell ratio in the active group and theinactive group had respectively comparative difference and the difference was statistically significant(P<0.05).The activegroup and the inactive group had respectively comparative differences with the control group in Th17and regulatory T cellratio and differences were statistically significant(P<0.05).Levels of IL-17,IL-6and IL-23of the active group and theinactive group had respectively comparative differences with the control group and differences were statistically significant(P<0.05).Percentage of serum MK and Th17,percentage of serum MK and T cell and results of correlation related to balanceshowed that Th17and Terg were both had no relation with serum MK,P>0.05while they were negatively correlated withSTAT5(P<0.05).Conclusion Serum MK of patients with rheumatoid arthritis increases,Th17in balance of Th17andTerg relatively increase and Terg relatively decreases.Increase of MK and imbalance of Th17and Terg both promote theoccurrence and development of RA.