急性胰腺炎患者Th17/Treg细胞平衡与IL-23/IL-17炎症轴的关系

Relationship between Th17/Treg cell balance and IL-23/IL-17 inflammatory axis in patients with acute pancreatitis

目的 研究急性胰腺炎患者辅助性T细胞17(Th17)/调节性T细胞(Treg)细胞平衡与白细胞介素23(IL-23)/白细胞介素17(IL-17)炎症轴的关系。方法 选择2018年6月-2021年6月河北省中医院收治的63例急性胰腺炎患者为观察组,另于同期选择63名健康成年人作为对照组,其中观察组依据急性胰腺炎严重程度分为轻度急性胰腺炎(MAP)19例、中度急性胰腺炎(MSAP)23例、重度急性胰腺炎(SAP)11例。检测两组外周血Th17、Treg细胞比例和血清IL-23、IL-17水平,比较观察组和对照组、不同严重程度急性胰腺炎患者的Th17、Treg、IL-23、IL-17水平,以Person系数检验急性胰腺炎患者Th17/Treg细胞平衡与IL-23/IL-17炎症轴的相关性。结果 与对照组相比,观察组Th17水平、Th17/Treg值较低,Treg、IL-23、IL-17水平较高(P<0.05);Th17、IL-23、IL-17水平及Th17/Treg值比较,MAP<MSAP<SAP,Treg水平比较,MAP>MSAP>SAP (P<0.05);经相关性分析,Th17、Th17/Treg值与IL-23、IL-17呈正相关,Treg与IL-23、IL-17呈负相关,差异有统计学意义(P<0.05)。结论 IL-23、IL-17、Th17、Treg水平均与急性胰腺炎患者的严重程度相关,并且随着炎症反应的加重,Th17/Treg比值增加,Th17/Treg细胞失衡越来越严重,这对临床治疗急性胰腺炎有一定指导意义。

Objective To investigate the relationship between helper T cell 17(Th17)/regulatory T cell(Treg)balance and interleukin-23(IL-23)/interleukin-17(IL-17)inflammatory axis in patients with acute pancreatitis.Methods A total of 63 patients with acute pancreatitis admitted to Hebei Hospital of Traditional Chinese Medicine from June 2018 to June 2021 were selected as the observation group,and 63 healthy adults were selected as the control group during the same period.The observation group was divided into 19 cases of mild acute pancreatitis(MAP),23 cases of moderate acute pancreatitis(MSAP)and 11 cases of severe acute pancreatitis(SAP)according to the severity of acute pancreatitis.And 63 healthy adults were randomLy selected as the control group.5 mL of peripheral venous blood sample was collected 3~6 h after onset from each subjects to measure the levels of regulatory T cells(Treg cells)and T helper type 17(Th17)cells so as to calculate the proportion thereof and to detect the levels of interleukin(IL)-23 and IL-17 in serum by ELISA.The correlation between Th17/Treg cell balance and IL-23/IL-17 inflammatory axis in thepatients with acute pancreatitis was tested by Pearson coefficient.Results Compared with the control group,the levels of Th17 and Th17/Treg in the observation group weresignificantly lower,while the levels of Treg cells,IL-23,and IL-17 were significantly higher(all P<0.05).The Th17,IL-23,and IL-17 levels and Th17/Treg value of the SAP subgroup were the highest,and those of the MSAP subgroup were all significantly higher than those of the MAP subgroup(all P<0.05).The Treg level of the MAP subgroup was the highest,and the Treg level of the MSA Psubgroup was significantly higher than that of the SAP subgroup(P<0.05).Correlation analysis showed that Th17 and Th17/Treg values were positively correlated with IL-23 and IL-17 levls,while the Treg value was negatively correlated with IL-23 and IL-17 levels(all P<0.05).Conclusion IL-23,IL-17,Th17 and Treg levels are all correlated with the severity of the condition of acute pancreatitis,and with the aggravation of inflammatory response,the Th17/Treg ratio increases,and the imbalance of Th17/Treg cells becomes more and more serious,which has certain guiding significance for the clinical treatment of acute pancreatitis.