EBV相关性噬血细胞综合征患儿外周血Th17与Treg细胞的变化及意义

Changes of frequencies of Th17 and Treg cells in the peripheral blood of Epstein-Barr virus associated Hemophagocytic syndrome patients

目的探讨EB病毒感染相关性噬血细胞综合征(hemophagocytic syndrome,HPS)患儿治疗前后外周血调节性T细胞与辅助T细胞17(Th17)的变化在HPS发生及治疗中的临床意义。方法选择本院2015年9月至2017年12月62例确诊为EBV相关性HPS患儿为治疗组,同时选取60例健康体检儿童为健康对照组。诱导缓解8周后评估疗效,抽取清晨空腹外周血提取单个核细胞(PBMC),分别采用流式细胞术检测各组外周血CD4^+T细胞Th17细胞和Treg细胞百分率,实时RT-PCR技术检测Th17表达孤核受体(RORγt)mRNA及Foxp3mRNA的表达。结果治疗组外周血CD4^+T细胞Th17细胞百分比和孤核受体(RORγt)mRNA水平明显高于健康对照组(P<0.01,P<0.01);HPS初治组外周血CD4^+Treg细胞和Foxp3蛋白mRNA表达水平明显低于健康对照组(P<0.01,P<0.01)。且治疗缓解组外周血CD4^+T细胞Th17细胞及RORγtmRNA水平较初治组下降(P<0.01,P<0.01),而外周血CD4^+Treg细胞百分比及Foxp3mRNA表达水平较初治时上升(P<0.05,P<0.05),结论EBV相关性HPS的发生发展与Th17细胞及Treg细胞变化有关,推测了Th17/Treg失衡参与了EBV相关性HPS的疾病发生、发展过程,且监测Th17细胞与调节性T细胞数目的动态变化对于疾病的转归预估有重大意义。

Objective To explore the changes of frequencies of Th17 and Treg cells in the peripheral blood of Epstein-Barr virus associated Hemophagocytic syndrome patients before and after treatment.Methods 62 patients with EBV associated HPS admitted in our hospital were collected.At the same time,60 cases accepted physical examination with physical fitness as control group.The frequencies of Th17 cells and Treg cells in the peripheral blood of the 3 groups were tested by flow cytometry instrument.The expression of(RORγt)mRNA and Foxp3mRNA were tested by Real-Time PCR.Results The proportion of Th17 cells and the expression of(RORγt)mRNA in initial treatment group raised obviously than patients in control group(P<0.01,P<0.01),while the proportion of Treg cells and the expression of Foxp3 mRNA in initial group decreased than that in the control group(P<0.01,P<0.01).The proportion of Th17 cells and the expression of(RORγt)mRNA in mitigation treatment group decreased obviously than patients in initial group(P<0.01,P<0.01),while the proportion of Treg cells and the expression of Foxp3 mRNA in mitigation group was raised than that in the initial group(P<0.05,P<0.05).Conclusion The unblance of Th17 cells and Treg cell which may play an important role in the development of the occurrence of HPS.Monitoring dynamic changes of Th17 cells and Treg cells will play a role in evaluating the curative effect of disease.