既往血吸虫病患者Th17/Treg失衡及相关细胞因子表达水平变化的意义

Significance of Th17/Treg cells imbalance and changes in related cytokines expression levels of previous schistosomiasis patients

目的研究湖北省重点区域既往血吸虫病患者辅助性T细胞17(helper T cell,Th17)/调节性T细胞(regula⁃tory T cell,Treg)平衡与相关细胞因子白细胞介素17(interleukin 17,IL-17)等水平表达的关系,以期为临床有效评估血吸虫病病情提供新的靶点。方法采取单纯随机抽样法,抽取2023年湖北省荆州市江陵县既往血吸虫病患者15例为病例组(P组);抽取2023年在湖北省疾病预防控制中心门诊体检且匹配的健康者15例作为对照组(C组)。比较2组受试者一般资料、临床资料,外周血Th17、Treg含量及Th17/Treg比值,相关细胞因子白细胞介素17(interleukin 17,IL-17)、IL-22、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、IL-10、转化生长因子β1(transforming growth factorβ1,TGF-β1)等水平表达。采用t检验对病例组与对照组在Th17/Treg平衡与相关细胞因子IL-17等方面水平表达进行分析,相关性分析采用Pearson相关分析。结果2组受试者在性别、年龄、身高、体质量方面差异无统计学意义(P>0.05)。病例组丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)[(75.24±12.73)、(61.96±11.82)U/L]较对照组[(18.42±1.21)、(16.35±0.92)U/L]均升高,差异有统计学意义(P<0.05)。病例组Th17百分率高于对照组,病例组Th17/Treg比值较对照组上升,差异具有统计学意义(P<0.05);2组Treg百分率差异无统计学意义(P>0.05)。病例组外周血IL-17表达水平高于对照组,差异有统计学意义(P<0.05);IL-22、TNF-α、IL-10、TGF-β1等表达水平比较,2组差异无统计学意义(P>0.05)。病例组外周血Th17(%)、细胞因子IL-17水平均与ALT、AST呈正相关性(P<0.05)。结论受炎性反应、免疫功能紊乱等因素影响,本研究既往血吸虫病患者体内呈现出Th17/Treg比值增加,Th17/Treg失衡现象,细胞因子IL-17水平表达异常。检测Th17/Treg及其相关细胞因子水平表达可能为血吸虫病临床病情评估与对症治疗提供参考依据。

Objective To study the relationship between the balance of helper T cell 17(Th17)/regulatory T cell(Treg)and the expression levels of related cytokines such as interleukin 17(IL-17),in key endemic areas of Hubei Province for previous schistosomiasis patients,to provide new targets for effective clinical assessment of the state of schistosomiasis.Methods A simple random sampling method was used to select previous schistosomiasis patients from Jiangling County,Jingzhou City,Hubei Province in 2023.And 15 cases were identified as the patient group(P group).Fifteen matched healthy individuals undergoing physical examination at the Hubei Provincial Center for Disease Control and Prevention in 2023 were selected as the control group(C group).The general and clinical data of the two groups were compared,along with the content of peripheral blood Th17,Treg,Th17/Treg ratio,and expression levels of related cytokines such as IL-17,IL-22,tumor necrosis factorα(TNF-α),interleukin 10(IL-10),and transforming growth factorβ1(TGF-β1).The t-test was used to analyze the levels of Th17/Treg cell balance and related cytokines(e.g.,IL-17)between the patient and control groups.Pearson correlation analysis was used for correlation analysis.Results There were no statistically significant differences between the two groups in terms of gender,age,height,and body mass(P>0.05).The serum biochemical indicators alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the patient group[(75.24±12.73)U/L,(61.96±11.82)U/L]were elevated compared to the control group[(18.42±1.21)U/L,(16.35±0.92)U/L],with statistically significant differences(P<0.05).The percentage of Th17 cells in the patient group was higher than that in the control group,and the Th17/Treg cell ratio was increased,with statistically significant differences(P<0.05).There was no statistically significant difference in the percentage of Treg cells between the two groups(P>0.05).The expression levels of IL-17 in peripheral blood were higher in the patient group compared to the control group,with a statistically significant difference(P<0.05),while the expression levels of IL-22,TNF-α,IL-10,TGF-β1 showed no statistically significant differences(P>0.05).The levels of Th17(%)and cytokine IL-17 in the peripheral blood of the patient group were significantly positively correlated with ALT and AST(P<0.05).Conclusions Influenced by factors such as inflammatory reactions and immune dysfunction,the subjects of this study showed an increase in the Th17/Treg ratio of previous schistosomiasis patients,resulting in an imbalance of Th17/Treg cells and abnormal expression of cytokine IL-17.Therefore,detecting the expression of Th17/Treg cells and their related cytokines may provide a reference for the clinical assessment and symptomatic treatment of schistosomiasis.