川崎病患儿不同时期外周血Th17/Treg细胞特异性转录因子以及相关细胞因子变化研究  

Study on the changes of specific transcription factors and related cytokines in peripheral blood Th17/Treg cells of Kawasaki disease children during different phases

作　　者：黎萍[1] 苟伟会[1] 张淑慧[1] 曾凡杰[1] 郑百红[1] 

机构地区：[1]吉林大学第二医院儿科,吉林长春130041

出　　处：《中国妇幼保健》2017年第9期1957-1962,共6页Maternal and Child Health Care of China

基　　金：吉林省科技厅青年基金资助课题(20140520022JH)

摘　　要：目的阐明Th17细胞特异性RORγt、相关细胞因子IL-17A、IL-6和Treg细胞特异性FOXP3、相关细胞因子IL-10、TGF-β在川崎病不同时期的表达以及与冠状动脉损伤(CAL)、静脉注射免疫球蛋白(IVIG)治疗反应性的关系。方法选择85例川崎病患儿为病例组,30例健康儿童为对照组,病例组患儿于开始IVIG治疗前、治疗后3、21 d取外周血,采用酶联免疫吸附法(ELISA)检测外周血细胞因子IL-10、IL-17A、TGF-β及IL-6水平,实时PCR检测RORγt mRNA和FOXP3mRNA表达水平。结果病例组患儿治疗前血中IL-17A、IL-6比对照组儿童高,差异有统计学意义(P<0.01);IVIG治疗3、21 d后IL-6显著低于治疗前,差异有统计学意义(P<0.01)。血IL-17A在治疗3 d后有所下降,但与治疗前相比差异无统计学意义(P>0.05);治疗21 d后IL-17A显著下降,但仍高于对照组,差异有统计学意义(P<0.01)。IL-10明显高于对照组(P<0.01),而TGF-β与对照组差异无统计学意义(P>0.05);IVIG治疗3 d后IL-10无显著下降(P>0.05),TGF-β水平在IVIG治疗前、治疗后3、21 d差异无统计学意义(P>0.05)。与对照组儿童比,病例组患儿治疗前外周血细胞FOXP3 mRNA表达水平差异无统计学意义(P>0.05),治疗3 d时FOXP3 mRNA表达水平显著上升,RORγt mRNA显著升高,差异均有统计学意义(P<0.01);治疗3、21 d时Th17的RORγt mRNA表达水平均有所下降,仍高于对照组儿童。川崎病CAL患儿IL-10、IL-17A均高于无CAL患儿,IVIG无反应型的川崎病患儿IL-10及IL-17A均高于IVIG敏感型的患儿,差异均有统计学意义(P<0.01)。结论川崎病患儿急性期外周血中Th17的转录因子RORγt以及细胞因子IL-17A、IL-6升高,而Treg细胞特异性FOXP3及其细胞因子IL-10降低;川崎病患儿外周血IL-17A的持续高水平与川崎病IVIG无反应以及CAL有关。本研究为阐明川崎病的发病机制以及治疗提供了科学依据,为IVIG无反应以及IVIG治疗的敏感性判断提供了潜在的标志物。Objective To illuminate the expressions of RORγt, IL-17A, IL-6, FOXP3, IL-10, and TGF-β in peripheral blood Th17/Treg cells of Kawasaki disease children during different phases and the relationships with coronary artery lesion （CAL） , reactivity of intravenous injection of immunoglobulin （IVIG） . Methods Eighty-five children with Kawasaki disease were selected as ease group, thirty healthy children were selected as control group. Peripheral blood samples were collected from the children in case group before treatment and at 3, 21 days after treatment, ELISA was used to detect the levels of IL-10, IL-17A, TGF-β, and IL-6; real-time PCR was used to de- tect the expression levels of RORγt mRNA and FOXP3 mRNA. Results Before treatment, the levels of IL-17A and IL-6 in case group were statistically significantly higher than those in control group （P〈0. 01 ）. At 3 and 21 days after treatment, IL-6 levels after treatment were statistically significantly lower than before treatment in case group （ P〈0. 01 ）. IL-17A level at 3 days after treatment decreased in case group, but compared with before treatment, there was no statistically significant difference （ P〉0. 05 ） . IL-17A level at 21 days after treat- ment decreased significantly in case group, but it was still significantly higher than that in control group （ P〈0. 01 ） . IL-10 level was statis- tically significantly higher than that in control group （ P〈0. 01 ） , but there was no statistically significant difference in TGF-β level between the two groups （P〉0. 05 ） . IL-10 level at 3 days after treatment didn＇t decrease significantly （P〉0. 05 ） . There was no statistically signif- icant difference in TGF-[3 level between before treatment and at 3 and 21 days after treatment （P〉0. 05） . Before treatment, there was no statistically significant difference in the expression level of FOXP3 mRNA between the two groups （ P〉0. 05 ） ; at 3 days after treatment, the expression levels of FOXP3 mRNA and RORγt

关 键 词：川崎病 TH17细胞 TREG细胞 细胞因子 免疫球蛋白 

分 类 号：R725.4[医药卫生—儿科]