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目的从Th17及其相关细胞因子与Th1、Th2、Treg的相互关系,探讨轻、中度CHB患者CD4~+T淋巴细胞的整体免疫失衡状态。方法选择轻、中度CHB患者,与健康志愿者进行比较,观察其外周血各免疫细胞(Th17、Th1、Th2、Treg、Th1/Th2、Treg/Th17)、相关细胞因子(IL-17、IL-6、TGF-β、IFN-γ、IL-4)、主要效应分子(穿孔素、颗粒酶B)和核转录因子(孤独核受体RORγt、Foxp3等)的变化及其相互关系。结果与健康志愿者相比,CHB患者CD8~+T淋巴细胞比例更高,CD4~+/CD8~+比例显著下降,差异有统计学意义(P<0.01);与健康志愿者相比,CHB患者Th1细胞比例更高,Th1/Th2显著升高,差异有统计学意义(P<0.01);与健康志愿者相比,CHB患者Th17细胞比例更高,Treg/Th17比例显著下降,差异有统计学意义(P<0.01);与健康志愿者相比,CHB患者穿孔素和颗粒酶B的表达更高,差异有统计学意义(P<0.01);与健康志愿者相比,CHB患者FOXP3、IL17mRNA和RORγt的表达差异无统计学意义(P>0.05);与健康志愿者相比,CHB患者TGF-B1、IL-6、IL-17显著增高,差异有统计学意义(P<0.01);IFN-γ和IL-4的表达差异无统计学意义(P>0.05)。结论轻、中度CHB患者在免疫细胞及其相关细胞因子、效应分子等各环节,尤其是Treg/Th17比例,均处于严重的免疫失衡状态。
Objective To investigate the relationship between Th17 and its related cytokines and Th1, Th2, Treg in patients with mild to moderate CHB CD4 ~ + T lymphocytes in the overall immune imbalance. Methods The levels of Th17, Th1, Th2, Treg, Th1 / Th2 and Treg / Th17 in peripheral blood and the levels of IL-17 and IL-17 in serum of CHB patients with mild or moderate CHB were compared with those of healthy volunteers. -6, TGF-β, IFN-γ, IL-4), the major effector molecules (perforin, granzyme B) and nuclear transcription factors (nuclear receptor RORγt, Foxp3, etc.) Results Compared with healthy volunteers, CHB patients had a higher proportion of CD8 + T lymphocytes and a significantly lower CD4 ~ + / CD8 + ratio (P <0.01). Compared with healthy volunteers, CHB Compared with healthy volunteers, the proportion of Th17 cells in patients with CHB was higher, the proportion of Treg / Th17 was significantly decreased, the difference was statistically significant (P <0.01), the proportion of Th1 cells was higher, Th1 / Th2 was significantly higher (P <0.01). Compared with healthy volunteers, the expression of perforin and granzyme B in CHB patients was significantly higher than that in healthy volunteers (P <0.01). Compared with healthy volunteers, FOXP3, There were no significant differences in the expression of IL17 mRNA and RORγt (P> 0.05). Compared with healthy volunteers, the levels of TGF-B1, IL-6 and IL-17 in CHB patients were significantly increased There was no significant difference in the expression of IFN-γ and IL-4 (P> 0.05). Conclusions Patients with mild or moderate CHB are in a state of severe immune imbalance in various aspects of immune cells and their related cytokines and effector molecules, especially the proportion of Treg / Th17.