外周血IL-17、HMGB1水平诊断不明原因复发性流产价值及其与Th17/Treg细胞关系

Value of the interleukin-17 and high mobility group protein B1 levels in peripheral blood of women for diagnosing their unexplained recurrent spontaneous abortion and their correlation with the Th17/Treg cells

目的:探索不明原因复发性流产(URSA)患者外周血白细胞介素-17(IL-17)、高迁移率族蛋白B 1(HMGB1)水平与辅助性细胞Th17及调节细胞Treg细胞的关系。方法:回顾性选取2019年3月-2020年3月本院就诊的URSA孕妇60例为URSA组,体检健康孕妇60名为对照组。检测两组HMGB1、RAGE、Th17、Treg、Th17/Treg、IL-6、IL-10、IL-17、转化生长因子-β(TGF-β)等指标。分析外周血IL-17、HMGB1水平与Th17/Treg细胞的关系及对URSA的预测价值。结果:URSA组Th17细胞、Th17/Treg值、HMGB1、IL-6、IL-17水平高于对照组,Treg细胞、TGF-β、IL-10水平低于对照组;IL-17、HMGB1水平与Th17、Th17/Treg、IL-6呈正相关,与Treg、TGF-β、IL-10呈负相关(均P<0.05)。受试者工作曲线分析显示,IL-17、HMGB1水平预测URSA(AUC=0.790、0.980)均有一定准确性,预测敏感度(50.0%、95.0%)、特异度(100.0%、99.5%)。两项联合预测AUC为0.977,敏感度96.7%、特异度91.7%。结论:URSA患者外周血IL-17、HMGB1水平异常高表达,与Th17/Treg细胞呈正相关,血IL-17、HMGB1诊断URSA有一定参考价值。

Objective:To explore the relationship between the levels of interleukin(IL)-17 and high mobility group protein B 1(HMGB1)in peripheral blood of women with unexplained recurrent spontaneous abortion(URSA)and their Th17/Treg cells value.Methods:60 women with URSA(in study group)and 60 healthy pregnant women(in control group)from March 2019 to March 2020 were selected retrospectively.The levels of HMGB1,RAGE,Th17,Treg,IL-6,IL-10,IL-17,and transforming growth factor(TGF)-β,and the value of Thl7/Treg of the women in the two groups were detected.The relationship between IL-17 and HMGB1 levels in peripheral blood of the women and their Th17/Treg value was analyzed.The predictive value of the IL-17 and HMGB1 levels for URSA was also analyzed.Results:The levels of Th17 cells,HMGB1,IL-6,and IL-17,and the value of Th17/Treg of the women in the study group were significantly higher than those of the women in the control group,while the levels of Treg cells,TGF-β,and IL-10 of the women in the study group were significantly lower.The levels of Il-17 and HMGB1 of the women were positively correlated with their Th17 and IL-6 levels and their value of Th17/Treg,but were negatively correlated with their levels of Treg,TGF-β,and IL-10(all P<0.05).Receiver operating characteristic analysis showed that IL-17 and HMGB1 levels had certain accuracy for predicting URSA(AUC=0.790,0.980),with the sensitivity(50.0%,95.0%)and the specificity(100.0%,99.5%).The AUC,the sensitivity,and the specificity of the combination of IL-17 and HMGB1 levels for predicting URSA were 0.977,96.7%,and 91.7%,respectively.Conclusion:The levels of IL-17 and HMGB1 in the peripheral blood of the women with URSA are abnormally high,which are positively correlated with the Th17/Treg value.Therefore,the prediction and diagnosis of URSA by the IL-17 and HMGB1 levels in blood has certain reference value.