成人过敏性紫癜肾炎外周血Treg/Th17细胞轴表达与中医证型的相关性  

Correlation Between Expression of Treg/Th17 Cell Axis in Peripheral Blood and TCM Syndrome Type in Adults with HSPN Patients

作　　者：薛雪 柳强[2] 王小琴[2] 袁军 韩四萍[2] Xue Xue;Liu Qiang;Wang Xiaoqin;Yuan Jun;Han Siping(Hubei University of Chinese Medicine,Wuhan 430061,China;Hubei Provincial Hospital of TCM,Wuhan 430061,China)

机构地区：[1]湖北中医药大学第一临床学院,武汉430061 [2]湖北省中医院肾病科,武汉430061

出　　处：《世界科学技术-中医药现代化》2020年第8期2907-2913,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：湖北省教育厅科学技术研究中青年人才项目(Q20192005):基于成人过敏性紫癜性肾炎队列研究—探讨外周血Treg/Th17细胞表达与中医证型的相关性,负责人:薛雪

摘　　要：目的探讨成人过敏性紫癜肾炎患者外周血调节性T细胞(Regulatory T cell,Treg cell)/辅助性T细胞17(T helper 17 cell,Th17 cell)的表达及与中医证型的相关性。方法43例成人过敏性紫癜肾炎患者及13例健康对照者,分别采用流式细胞术、实时定量聚合酶链反应和酶联免疫吸附法检测两组受试者外周血Treg细胞与Th17细胞阳性表达率,叉头翼状螺旋核转录因子3(forkhead/winged helix nuclear transcription factor 3,Foxp3)和维甲酸受体相关孤儿受体γt(Retinoic receptor-related orphan receptorγt,RORγt)mRNA的表达及白介素-10(Interleukin-10,IL-10)和IL-17的浓度。结果成人过敏性紫癜肾炎患者外周血Treg细胞阳性表达率(P<0.05)、Foxp3 mRNA(P<0.05)及IL-10(P<0.01)表达水平较健康受试者降低;而Th17细胞阳性表达率(P<0.05)、RORγt mRNA(P<0.05)及IL-17(P<0.01)表达水平较健康受试者升高。与其他中医证型相比,气阴两虚证型患者外周血Treg细胞阳性表达率(P<0.01)及IL-10(P<0.05)浓度较低,肝肾阴虚火旺证型患者外周血IL-17浓度较高(P<0.05)。结论Treg/Th17细胞轴失衡参与了成人过敏性紫癜肾炎的发病过程。在整个过程中,机体气血阴阳失调与Treg/Th17细胞轴失衡变化密切相关。Objective To investigate the expression of regulatory T(Treg)cells/T helper17(Th17)cells in peripheral blood of patients with Henoch-Schonlein purpura nephritis(HSPN)in adults and its correlation with TCM syndromes.Methods 43 adult patients of HSPN and 13 healthy control subjects were tested by flow cytometry,real-time quantitative polymerase chain reaction(PCR)and enzyme-linked immunosorbent assay methods to detect the positive expression percentage of Treg and Th 17;expression of forkhead/winged helix nuclear transcription factor 3(Foxp3)and retinoic receptor-related orphan receptorγt(RORγt)mRNA;as well as concentration of interleukin-10(IL-10)and interleukin-17(IL-17)in peripheral blood.Results Compared with healthy control group,the positive expression percentage of Treg(P<0.05),level of Foxp3 mRNA(P<0.05)and IL-10(P<0.01)in peripheral blood with HSPN patients in adults decreased.By contrast,the positive expression percentage of Th17(P<0.05),level of RORγt mRNA(P<0.05)and IL-17(P<0.01)were increased compared with healthy controls.Compared with other TCM syndromes,the positive expression percentage of Treg(P<0.01)and concentration of IL-10(P<0.05)in peripheral blood were lower in patients with deficiency syndrome of Qi-Yin.And the increase of IL-17 in patients with deficiency of Yin of the liver-kidney and excess of fire syndrome were more obvious than other TCM syndromes(P<0.05).Conclusion The imbalance of Treg/Th17 cell axis participated in the pathogenesis of HSPN in adults.Throughout whole process,the imbalance of Qi-blood and Yin-Yang in the body was closely related to the imbalance of the Treg/Th17 cell axis.

关 键 词：过敏性紫癜肾炎 成人 Treg/Th17 中医证型 

分 类 号：R259[医药卫生—中西医结合]