肺炎支原体感染对过敏性紫癜患儿外周血Th17/Treg平衡及病情进展的影响

Influence of Mycoplasma pneumoniae infection on peripheral blood Th17/Treg balance and illness condition of children with Henoch-Schonlein purpura

目的探究肺炎支原体(MP)感染对过敏性紫癜(HSP)患儿外周血辅助型T细胞17/调节型T细胞(Th17/Treg)平衡及病情进展的影响。方法选取2019年1月-2021年3月在新乡市中心医院接受治疗的HSP合并MP感染患儿40例为M-HSP组,HSP未合并MP感染患儿52例为HSP组,两组患儿依据病情分为轻、中和重症,选取同时期的健康体检儿童90名为健康组。流式细胞仪检测三组外周血Th17/Treg细胞百分率,酶联免疫吸附法检测白细胞介素(IL)-6、IL-17和转化生长因子-β(TGF-β)。结果三组TGF-β比较,无统计学差异,但Th17/Treg细胞百分率、血清IL-6、IL-17水平差异有统计学意义(P<0.05);M-HSP组、HSP组患儿Th17细胞百分率、IL-6、IL-17高于健康组,Treg细胞百分率低于健康组(P<0.05);M-HSP组Th17细胞百分率、IL-6、IL-17高于HSP组,Treg细胞百分率低于HSP组(P<0.05);M-HSP组患儿重症HSP占比高于HSP组(P<0.05),重症组、中症组患儿的Th17细胞百分率、IL-6、IL-17高于轻症组,Treg细胞百分率低于轻症组(P<0.05);重症组Th17细胞百分率、IL-6、IL-17高于中症组,Treg细胞百分率低于中症组(P<0.05)。结论MP感染可加重HSP患儿Th17/Treg平衡失衡,升高Th17细胞百分率、降低Treg细胞百分率,升高促炎因子IL-6、IL-17血清水平,可促进HSP病情的发展,不利于HSP患儿预后。

OBJECTIVE To explore the influence of Mycoplasma pneumoniae(MP)infection on peripheral blood helper T cell 17(Th17)/regulatory T cell(Treg)balance and illness condition of children with Henoch-Schonlein purpura(HSP).METHODS A total of 40 HSP children complicated with MP infection who were treated in Xinxiang Central Hospital from Jan 2019 to Mar 2021 were assigned as the M-HSP group,and 52 HSP children who were not complicated with MP infection were assigned as the HSP group,the two groups of children were divided into the mild,moderate and severe groups,meanwhile,90 healthy children who received physical examination were chosen as the healthy group.The peripheral blood Th17/Treg percentage was detected by flow cytometry,and the interleukin(IL)-6,IL-17 and transforming growth factor--β(TGF-β)were detected by enzyme-linked immunosorbent assay.RESULTS There was no significant difference in TGF-βamong the three groups,there were significant differences in the Th17/Treg percentage,serum IL-6 level and IL-17 level(P<0.05).The Th17 percentage,IL-6 level and IL-17 level of the M-HSP group and the HSP group were higher than those of the healthy group,while the Treg percentage of the M-HSP group and the HSP group was lower than that of the healthy group(P<0.05);the Th17 percentage,IL-6 level and IL-17 level of the M-HSP group were higher than those of the HSP group,while the Treg percentage of the M-HSP group was lower than that of the HSP group(P<0.05).The proportion of children with severe HSP was higher in the M-HSP group than in the HSP group(P<0.05).The Th17 percentage,IL-6 level and IL-17 level of the severe group and the moderate group were higher than those of the mild group,while the Treg percentage of the severe group and the moderate group was lower than that of the mild group(P<0.05);the Th17 percentage,IL-6 level and IL-17 level of the severe group were higher than those of the moderate group,while the Treg percentages of the severe group was lower than that of the moderate group(P<0.05).CONCLUSION The MP infection may aggravate the imbalance of Th17/Treg of the children with HSP,raise the levels of serum proinflammatory factors and further aggravate the condition of HSP.