Periostin、Notch1、维生素D与自身免疫性甲状腺炎淋巴细胞浸润程度、Treg/Th17的相关性研究

Correlation of Periostin,Notch1,and Vitamin D with the degree of lymphocyte infiltration and Treg/Th17 in autoimmune thyroiditis

目的探讨骨外膜素(Periostin)、Notch跨膜受体-1(Notch1)m RNA、维生素D(VitD)与自身免疫性甲状腺炎(AIT)淋巴细胞浸润程度、调节性T细胞/辅助性T细胞17(Treg/Th17)的相关性。方法选取2021年7月至2023年12月郑州大学第一附属医院收治的92例AIT患者纳入AIT组,另选取同期50例无甲状腺疾病的健康人群纳入对照组。比较两组受检者的淋巴细胞浸润程度及抗体水平,采用Spearman、Pearson相关系数分析淋巴细胞浸润程度、Treg/Th17与甲状腺功能、抗体水平的相关性,比较两组受检者的Periostin、Notch1 m RNA、VitD及Treg/Th17,采用Pearson相关系数分析Periostin、Notch1 mRNA、VitD与淋巴细胞浸润程度及Treg/Th17的相关性。结果AIT组患者的CD3^(+)、CD3^(+)CD4^(+)、CD4^(+)CD25^(+)CD127^(-)、TgAb、TPOAb、TRAb水平及甲亢/亚临床甲亢、甲减/亚临床甲减患者占比明显高于对照组,差异均有统计学意义(P<0.05);Pearson相关系数分析结果显示,CD3^(+)(r=0.579、0.602、0.563)、CD3^(+)CD4^(+)(r=0.612、0.637、0.606)、CD~4+CD25^(+)CD127^(-)(r=0.655、0.643、0.687)与TgAb、TPOAb、TRAb呈正相关(P<0.05);AIT组患者的Periostin、Notch1 m RNA分别为(4.27±1.40)μg/L、1.73±0.56,明显高于对照组的(2.86±0.49)μg/L、1.02±0.14,VitD、Treg/Th17分别为(17.82±5.09)ng/mL、2.82±0.97,明显低于对照组的(22.30±3.76)ng/mL、12.36±2.03,差异均有统计学意义(P<0.05);Pearson相关系数分析结果显示,Periostin(r=0.792、0.811、0.737)、Notch1 mRNA(r=0.812、0.775、0.792)与CD3^(+)、CD3^(+)CD4^(+)、CD4^(+)CD25+CD127-呈正相关(P<0.05),VitD(r=-0.687、-0.753、-0.799)与之呈负相关(P<0.05),且Periostin(r=-0.823)、Notch1 m RNA(r=-0.772)与Treg/Th17呈负相关(P<0.05),VitD(r=0.745)与之呈正相关(P<0.05)。结论Periostin、Notch1 mRNA在AIT患者血清中表达上调,VitD表达下调,各指标与AIT淋巴细胞浸润程度及Treg/Th17均具有一定相关性,可为临床判断病情提供参考,并对后续临床治疗具有一定指导价值。

Objective To investigate the correlation of Periostin,Notch transmembrane receptor-1(Notch1)mRNA,and vitamin D(VitD)with the degree of lymphocyte infiltration and regulatory T cell/helper T cell 17(Treg/Th17)in autoimmune thyroiditis(AIT).Methods A total of 92 patients with AIT admitted to the First Affiliated Hospi-tal of Zhengzhou University from July 2021 to December 2023 were selected as the AIT group,and 50 healthy individu-als without thyroid disease were selected as the control group.The degree of lymphocyte infiltration and antibody levels were compared between the two groups of subjects.Spearman and Pearson correlation coefficients were used to analyze the correlation between lymphocyte infiltration,Treg/Th17 and thyroid function,antibody levels.The Periostin,Notch1 mRNA,VitD,and Treg/Th17 levels were compared between the two groups of subjects,and Pearson correlation coeffi-cients were used to analyze the correlation of Periostin,Notch1 mRNA,and VitD with lymphocyte infiltration and Treg/Th17.Results The levels of CD3^(+),CD3^(+)CD4^(+),CD4^(+)CD25^(+)CD127^(-),TgAb,TPOAb,TRAb,and the proportions of pa-tients with hyperthyroidism/subclinical hyperthyroidism and hypothyroidism/subclinical hypothyroidism in the AIT group were significantly higher than those in the control group(P<0.05).Pearson correlation analysis showed that CD3^(+)(r=0.579,0.602,0.563),CD3^(+)CD4^(+)(r=0.612,0.637,0.606),and CD4^(+)CD25^(+)CD127^(-)(r=0.655,0.643,0.687)were positively correlated with TgAb,TPOAb,and TRAb(P<0.05).The Periostin and Notch1 mRNA levels in the AIT group were(4.27±1.40)μg/L and 1.73±0.56,respectively,which were significantly higher than(2.86±0.49)μg/L and 1.02±0.14 in the control group,respectively;the VitD and Treg/Th17 levels were(17.82±5.09)ng/mL and 2.82±0.97,respectively,which were significantly lower than(22.30±3.76)ng/mL and 12.36±2.03 in the control group,respectively;the differenc-es were statistically significant(P<0.05).Pearson correlation analysis showed that Periostin(r=0.792,0.811,0.737)and-Notch1 mRNA(r=0.812,0.775,0.792)were positively correlated with CD3^(+),CD3^(+)CD4^(+),CD4^(+)CD25^(+)CD127(P<0.05),while VitD(r=-0.687,-0.753,-0.799)was negatively correlated with them(P<0.05);Periostin(r=-0.823)and Notch1 mRNA(r=-0.772)were negatively correlated with Treg/Th17(P<0.05),while VitD(r=0.745)was positively correlated with them(P<0.05).Conclusion Periostin and Notch1 mRNA expression levels were up-regulated in the serum of AIT patients,and VitD expression was down-regulated.All the three indexes were related to the degree of AIT lymphocyte infiltration and Treg/Th17,which could provide reference for clinical judgment of the disease and have certain guiding val-ue for subsequent clinical treatment.