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目的检测梅毒血清固定患者外周血中干扰素调节因子4(IRF4)、辅助性T细胞17(Th17细胞)及其相关细胞因子的表达,初步探讨IRF4和Th17在梅毒血清固定形成中的作用。方法梅毒血清固定患者32例,同时以32例健康体检者为对照,分别应用实时荧光定量PCR法检测外周血单一核细胞(PBMC)中IRF4、白细胞介素17(IL-17)和维甲酸相关孤儿受体γt(RORγt)信使核糖核酸(mRNA)的表达;流式细胞术检测Th17与IRF4在CD4+T淋巴细胞中的比例以及IRF4在Th17细胞中的比例。结果梅毒血清固定组PBMC中IRF4mRNA的表达和CD4+IRF4+T细胞的比例,分别为(3.04E-3±5.20E-4);(44.95±2.68)%,与健康对照组的(4.17E-3±2.01E-3)、(46.76±5.13)%相比,差异均无统计学意义(P>0.05)。血清固定组IL-17和RORγt mRNA的表达分别为(3.13E-5±1.18E-5)、(2.21E-4±3.47E-5),与健康对照组的(1.30E-4±4.09E-5)、(5.59E-4±8.39E-5)相比,显著下降,差异有统计学意义(P<0.05);CD4+T淋巴细胞中Th17比例及Th17中IRF4+T细胞比例,血清固定组为(1.35±0.17)%、(50.51±4.06)%,与健康对照组的(1.91±0.19)%、(65.72±4.61)%相比,显著降低,差异具有统计学意义(P<0.05)。结论 Th17可能参与了梅毒血清固定形成的免疫应答。IRF4在梅毒血清固定中可能不发挥直接作用,而是通过作用于Th17而发挥间接作用。
Objective To detect the expression of interferon regulatory factor 4 (IRF4), helper T cell 17 (Th17) and related cytokines in peripheral blood of patients with syphilis and to investigate the role of IRF4 and Th17 in the formation of syphilis serum. Methods Thirty-two patients with syphilis were enrolled in this study. 32 healthy controls were used as controls. The levels of IRF4, IL-17 and retinoic acid in peripheral blood mononuclear cells (PBMC) were detected by real-time PCR. The expression of messenger RNA (mRNA) of orphan receptor γt (RORγt) was detected by flow cytometry. The proportion of Th17 and IRF4 in CD4 + T lymphocytes and the proportion of IRF4 in Th17 cells were detected by flow cytometry. Results The expression of IRF4 mRNA and the percentage of CD4 + IRF4 + T cells in PBMC of syphilis serum-fixed group were (3.04E-3 ± 5.20E-4), (44.95 ± 2.68)% and 4.17E- 3 ± 2.01E-3) and (46.76 ± 5.13)%, respectively, with no significant difference (P> 0.05). The expression of IL-17 and RORγt mRNA in serum-fixed group were (3.13E-5 ± 1.18E-5), (2.21E-4 ± 3.47E-5) (P <0.05). The proportion of Th17 in CD4 + T lymphocytes and the proportion of IRF4 + T cells in Th17 cells were significantly lower than those in control group (5.59E-4 ± 8.39E-5) (1.35 ± 0.17)% and (50.51 ± 4.06)% in the fixed group were significantly lower than those in the healthy control group (1.91 ± 0.19) and (65.72 ± 4.61)%, respectively, with statistical significance (P <0.05 ). Conclusion Th17 may be involved in the immune response of syphilis serum. IRF4 may not play a direct role in syphilis sera but acts indirectly by acting on Th17.