过敏性紫癜并幽门螺杆菌感染患儿辅助性T淋巴细胞/调节性T淋巴细胞失衡的研究

Study on the imbalance of T helper 17 cells/regulatory T cells in children with Henoch-Schonlein purpura complicated with Helicobacter pylori infection

目的探讨过敏性紫癜(HSP)并幽门螺杆菌(HP)感染患儿辅助性T淋巴细胞17(Th17细胞)、调节性T淋巴细胞(Treg细胞)及相关细胞因子白细胞介素(IL)-17、IL-6的表达意义。方法选择2017年1月至2018年12月在厦门市妇幼保健院儿科住院并首次诊断为HSP急性期患儿和/或HP感染患儿作为研究对象,包括HSP-HP患儿15例(HSP-HP组)、HSP患儿26例(HSP组)、HP患儿21例(HP组);选取同期同年龄健康体检儿童20例作为健康对照组,应用流式细胞分析法检测外周血Th17细胞、Treg细胞的比例,应用酶联免疫吸附法(ELISA)检测血清IL-17、IL-6水平,分析和比较各组检测结果。结果1.与健康对照组[Th17(1.42±0.63)%、IL-17(302.96±82.83)ng/L、IL-6(7.81±2.04)ng/L、Treg(2.31±0.83)%]比较,HSP-HP组[Th17(2.79±0.78)%、IL-17(552.16±121.13)ng/L、IL-6(12.36±6.55)ng/L、Treg(1.35±0.49)%]、HSP组[Th17(2.04±0.77)%、IL-17(506.39±113.62)ng/L、IL-6(11.82±5.01)ng/L、Treg(1.13±0.86)%]、HP组[Th17(2.08±0.86)%、IL-17(483.14±121.77)ng/L、IL-6(10.19±3.87)ng/L、Treg(1.09±0.65)%]患儿Th17细胞比例、IL-17、IL-6水平均明显升高,差异均有统计学意义(F=5.271、13.113、6.692,均P<0.01);Treg细胞比例明显下降,差异有统计学意义(F=6.983,P<0.05)。2.HSP-HP组患儿的Th17细胞比例、IL-17水平均高于HSP组及HP组患儿,差异均有统计学意义(均P<0.05),HSP组和HP组患儿Th17细胞比例、IL-17水平差异均无统计学意义(均P>0.05);HSP-HP组、HSP组、HP组患儿组间比较Treg细胞比例、IL-6水平差异均无统计学意义(均P>0.05)。结论Th17/Treg表达失衡参与HSP-HP、HSP、HP的发病过程,Th17细胞及其相关细胞因子IL-17水平高表达在HSP-HP患儿中更为突出。

Objective To investigate the roles of T helper 17(Th17)cells and regulatory T(Treg)cells,interleukin(IL)-17 levels,and IL-6 levels in the pathogenesis of Henoch-Schonlein purpura(HSP)complicated with Helicobacter pylori(HP)infection in children.Methods Children diagnosed with acute HSP and/or HP infection by the Department of Pediatrics,Xiamen Maternal and Child Health Care Hospital from January 2017 to December 2018 were enrolled in the study.There were 15 children with HSP complicated with HP infection(HSP-HP group),26 children with HSP(HSP group),and 21 children with HP infection(HP group).Twenty healthy children of the same age over the same period were included in the healthy control group.The proportions of Th17 cells and Treg cells were tes-ted by flow cytometry(FCM),and concentrations of IL-17 and IL-6 in plasma were measured by enzyme linked immunosorbent assay(ELISA).Results(1)Compared with that of the healthy control group[(1.42±0.63)%],the proportion of Th17 cells in the HSP-HP group,HSP group and HP group[(2.79±0.78)%,(2.04±0.77)%,(2.08±0.86)%]was significantly increased(F=5.271,P<0.05).The levels of IL-17 and IL-6 in the HSP-HP group[(552.16±121.13)ng/L and(12.36±6.55)ng/L],HSP group[(506.39±113.62)ng/L and(11.82±5.01)ng/L]and HP group[(483.14±121.77)ng/L and(10.19±3.87)ng/L]were significantly higher than those in the healthy control group[(302.96±82.83)ng/L and(7.81±2.04)ng/L](F=13.113,6.692,all P<0.01).The proportion of Treg cells in the HSP-HP group[(1.35±0.49)%],HSP group[(1.13±0.86)%]and HP group[(1.09±0.65)%]was significantly lower than that in the healthy control group[(2.31±0.83)%](F=6.983,P<0.05).(2)The proportion of Th17 cells and the level of IL-17 in the HSP-HP group were significantly higher than those in the HSP and HP groups(all P<0.05).There was no significant difference in the proportion of Th17 cells and the level of IL-17 between the HSP group and HP group(all P>0.05).There was no significant difference in the proportion of Treg cells and the level of IL-6 among the HSP-HP group,HSP group,and HP group(all P>0.05).Conclusions The imbalance of Th17/Treg cells in peripheral blood may contribute to the development of HSP-HP,HSP and HP infection in children.High expression of Th17 cells and their related IL-17 is more prominent in children with HSP-HP.