桥本氏甲状腺炎患者Th17与调节性T细胞免疫失衡的研究

目的 检测桥本氏甲状腺炎(HT)患者甲状腺组织及外周静脉血中Th17细胞和调节性T 细胞(Treg)细胞相关细胞因子的表达水平,分析Th17/Treg免疫平衡在HT发病机制中的作用.方法 采用逆转录-聚合酶链反应(RT-PCR)法,检测10例HT甲功正常组、10例HT甲低组和10例正常甲状腺组织(对照组)中IL-17A...     

类风湿关节炎患者Th17细胞与调节性T细胞失衡的研究

目的观察类风湿性关节炎（RA）患者外周血Th17细胞与CD4^＋CD25^＋FoxP3^＋调节性T细胞（Treg）平衡状态与疾病的关系,分析Th17／Treg细胞免疫失衡在RA发病机制中的作用。方法采用流式细胞仪四色荧光抗体标记法分别对47例RA患者和39名健康志愿者（HVs）进行CD3、CD8、IL-17与CD4、CD25、F0xP3标记,测定Th17与调节性T细胞的比例变化及相关细胞因子IL-6、IL-23和IL-17水平。结果RA组患者外周血中,CD3^＋CD8^＋IL-17^＋T细胞占CD3^＋T淋巴细胞的百分比为（1．12±0．38）％,明显高于对照组（0．68±0．29）％（t=1．83,P〈0．05）;CD4’CD25’FoxP3^＋细胞占CD4^＋T淋巴细胞的百分比为（2．74±0．71）％,明显低于对照组（4．69±1．23）％（t=-2．94,P〈0．05）。相关细胞因子测定结果：IL-6水平在RA组为（13．5±3．7）ng／L,正常人为（4．6±0．9）ng／L（t=6．24,P〈0．01）;IL-23水平在RA组为（71±19）ng／L,正常人为（25±6）ng／L（t=14．37,P〈0．01）;IL-17水平在RA组为（122±33）ng／L,正常人为（37±9）ng／L（t=19．01,P〈0．01）;RA患者血清IL-6、IL-23和IL-17水平均明显升高。结论RA患者外周血Th17与CD4^＋CD25^＋FoxP3^＋调节性T细胞数量的异常可能是RA发病的重要因素,IL-6和IL-23的升高是引起这些改变的可能原因。     

成人哮喘患者Treg/Th17细胞失衡与呼出气一氧化氮的相关性研究

目的:探讨成人哮喘患者Treg/Th17细胞失衡与呼出气一氧化氮(FeNO)的相关关系。方法:募集成人哮喘患者17例,慢性咳嗽非哮喘患者16例。所有患者均检测FeNO值,并用ELISA法检测血浆IL-17的表达水平,流式细胞术检测外周血中Treg、Th17细胞占CD4~+T淋巴细胞比例。比较两组患者FeNO水平的差异及其与Treg/Th17的相关关系。结果:与慢性咳嗽组相比,哮喘组血浆IL-17浓度升高(P<0.05)、外周血Th17/CD4~+T细胞比值升高(P<0.001)、FeNO水平升高(P<0.001)、Treg/Th17细胞的比值降低(P<0.001),而Treg/CD4~+细胞比值无明显变化(P>0.05)。哮喘组FeNO值与外周血Treg/CD4~+T细胞比值无明显相关性,而与Th17细胞占CD4~+T淋巴细胞比例呈正相关(r=0.663,P=0.01),与Treg/Th17细胞比值呈负相关(r=-0.757,P=0.002)。结论:哮喘患者FeNO水平升高与Treg/Th17失衡有关,主要与Th17细胞表达升高有关。     

Extracorporeal photochemotherapy restores Th1/Th2 imbalance in patients with early stage cutaneous T-cell lymphoma.

Extracorporeal photochemotherapy (ECP) has been shown to be a potent activator of peripheral blood macrophages because it causes a marked release of macrophage-dependent proinflammatory cytokines, and it is therefore currently considered to be a safe and non-toxic immunomodulatory treatment. On this basis we studied the function of peripheral blood mononuclear cells (PBMC) in eight patients with early stage (Ib) cutaneous T-cell lymphoma (CTCL), before and 1 year after ECP, together with their clinical and histological responses. In particular we evaluated in vitro phytohaemagglutinin (PHA)-stimulated proliferation and production of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) as well as lipopolysaccharide (LPS)-induced production of IL-12. Before treatment we observed that PBMC of patients produced significantly higher levels of IL-4 and lower levels of IFN-gamma and IL-12 than those of healthy control subjects. After 1 year of ECP, IL-4, IFN-gamma and IL-12 production no longer differed from that of control subjects. Moreover, we observed a good clinical result matched by histological response. Our data confirm that early-stage CTCL patients show a predominantly type-2 immune response that might be responsible for several immunological abnormalities found in this disease. We have demonstrated that ECP reverses the T-helper type 1/T-helper type 2 (Th1/Th2) imbalance and may therefore be considered an efficient biological response modifier.     

过敏性哮喘患者调节性T细胞对Th17细胞和Th9细胞的影响

目的:深入研究过敏性哮喘病人(轻到中度)急性发作期的调节性T细胞对Th17和Th9细胞功能影响的异常。方法:招募30例过敏性哮喘病人(轻到中度)急性发作期和30例健康者,采集外周静脉血30 ml,分离PBMC,然后应用磁珠法体外分离CD4+CD25+CD127-/low调节性T细胞(Tregs)和CD4+CD25-效应T细胞(选取分离纯度90%以上的标本继续下一步试验)。在PHA刺激下体外培养,检测效应T细胞增殖情况和Th17细胞、Th9细胞特异性基因(RORC和PU.1)表达及特异性细胞因子(IL-17和IL-9)分泌情况,检测哮喘病人Th17细胞和Th9细胞的异常情况;并给予Tregs干预,检测Tregs对Th17细胞和Th9细胞分化的影响。结果:哮喘组和健康对照组的Tregs均可以抑制CD4+CD25-效应细胞增殖反应,但哮喘组Tregs的抑制功能较健康对照组明显下降(P=0.03)。哮喘病人RORC表达和IL-17分泌均高于对照组(P0.05),Tregs对RORC表达的抑制能力在哮喘组有所下降(P0.05),但对IL-17分泌的抑制能力在哮喘组和对照组没有显著差别(P0.05);哮喘病人IL-9分泌无论是否加入Tregs干预均高于对照组(P0.05),但PU.1表达只有在加入Tregs干预后才高于对照组(P=0.04);Tregs对PU.1表达和IL-9分泌的抑制能力在哮喘组和对照组没有显著差别(P0.05)。结论:过敏性哮喘病人(轻到中度)急性发作期Tregs数量和功能下降,而Th17细胞和Th9细胞的特异性基因表达和特异性细胞因子生成增加,哮喘病人的Tregs在体外对Th17细胞的抑制功能有所下降,但尚未发现Tregs对Th9细胞的抑制功能明显降低。     

T regulatory cells and Th1/Th2 cytokines in peripheral blood from tuberculosis patients

About 10% of people infected with Mycobacterium tuberculosis develop active tuberculosis (TB), and Th1 effector cells and Th1 cytokines play key roles in controlling M. tuberculosis infection. Here, we hypothesise that this susceptibility to M. tuberculosis infection is linked to increased T regulatory (Treg) cells and Th2 cytokines in TB patients. To test this, we recruited 101 participants (71 TB patients, 12 non-TB pulmonary diseases and 18 healthy subjects) and investigated Treg cells and Th1/Th2 cytokines in peripheral blood. CD4⁺CD25⁺ T cells and CD4⁺CD25⁺FoxP3⁺ T cells significantly increased and IL-5 dramatically decreased in TB patients relative to healthy subjects. CD8⁺CD28⁻ T cells, IFN-γ, TNF-α, IL-10 and IL-4 significantly increased in patients with culture and sputum smear-positive pulmonary TB (PTB(+)) compared with healthy subjects. CD4⁺CD25⁺FoxP3⁺ and CD8⁺CD28⁻ T cells significantly decreased in PTB(+) after one month of chemotherapy. CD4⁺, CD4⁺CD25⁺ and CD8⁺CD28⁺ T cells significantly increased in extra-pulmonary TB patients after one month of chemotherapy. These findings suggest that M. tuberculosis infection induces circulating CD4⁺CD25⁺FoxP3⁺ and CD8⁺CD28⁻ T cell expansion, which may be related to the progression of M. tuberculosis infection, and that the balance between effector immune responses and suppression immune responses is essential to control M. tuberculosis infection.     

Low-dose cyclophosphamide combined with IL-2 inhibits tumor growth by decreasing regulatory T cells and increasing CD8+ T cells and natural killer cells in mice

Interleukin-2 (IL-2) benefits some cancer patients by promoting the proliferation of cytotoxic effector T cells, but this process is limited by the expansion of regulatory T cells (Tregs). Low-dose cyclophosphamide (CTX) can inhibit the number and function of Tregs. We treated carcinoma-bearing mice with Vehicle, CTX, IL-2 and CTX + IL-2 to investigate the effects of low-dose CTX combined with IL-2 in antitumor treatment. In comparison to monotherapy, CTX + IL-2 significantly limited tumor growth, via tumor cell proliferation inhibition and increased apoptosis. The infiltration of CD8⁺ T cells in tumor tissues was significantly increased in the CTX + IL-2 group. CTX + IL-2 safely increased CD8⁺ T and natural killer cells in the spleen, lymph nodes and peripheral blood, and CTX attenuated the increase in Tregs induced by IL-2 in the spleen.     

Immunomodulation of human CD19+CD25high regulatory B cells via Th17/Foxp3 regulatory T cells and Th1/Th2 cytokines

Regulatory B (Breg) cells are a special subset of immunoregulatory cells with unique phenotypes and functions. In this study, human CD19⁺CD25^high Breg cells were purified from human peripheral blood. Based on the coculture system of Breg cells and CD4⁺ T cells in vitro, Breg cells were found to promote the increase in regulatory T (Treg) cells while decreasing the number of Th17 cells. Breg cells regulate Treg cells through two processes: cell-cell contact and cytokines. TGF-βsRII, a blocker of transforming growth factor-β (TGF-β), can attenuate the effects of Treg elevation, suggesting that TGF-β is the main cytokine, while Breg cells rather than interleukin-10 (IL-10) regulate the differentiation of Treg cells. However, Th17 cells were mainly regulated by cytokines, without an obvious regulatory effect on cell-cell contacts. Breg cells may regulate Th17 cells by a pathway independent of TGF-β and IL-6. The coculture of Breg cells and CD4⁺ T cells led to changes in the cytokine spectrum, which included significant increases in IL-4, IL-6 and IL-10 but not obvious changes in IL-2, IFN-γ and TNF. The inhibitory effect of Breg cells was weakened by blocking cell-cell contacts in cultures separated with the Transwell chamber because IL-10 decreased while IL-6 increased when compared with cocultured Breg and CD4⁺ T cells. When the IL-10 inhibitor IL-10sRα was added, IL-6 and TNF levels significantly increased, while treatment with the TGF-β inhibitor TGF-βsRII did not result in similar changes, suggesting that IL-10 is an important molecule to inhibit the proinflammatory factors IL-6 and TNF in this culture system.     

慢性乙肝患者肝内IL-23/IL-17信号途径与Treg细胞之间的相互作用

目的探讨慢性乙肝患者体内FOXP3蛋白与炎症因子IL-23/IL-17信号途径之间的相互关系。方法采用qPCR、流式细胞术分析了39例慢性乙肝急性发作(ACLF)、56例慢性乙肝(CHB)及32例健康对照(HC)肝组织及外周血中的FOXP3及IL-23/IL-17信号途径相关炎症因子的表达,免疫组化及荧光共聚焦检测FOXP3在肝组织内的表达,定量PCR检测血清HBV DNA水平,酶联免疫吸附试验检测HBsAg浓度,全自动生化仪检测血清谷丙转氨酶(ALT)水平。结果 CHB患者外周血及肝组织内FOXP3 mRNA表达明显升高,肝内的FOXP3表达水平与患者血液中的HBV DNA水平及乙肝表面抗原(HB-sAg)浓度明显呈正相关。与健康对照组相比,慢性乙肝患者肝脏内的IL-23/IL-17信号通路相关的促炎因子也明显升高,且与FOXP3的表达水平升高呈正相关。结论 HBV感染的肝脏内IL-23/IL-17信号通路的活化并没有有效地被宿主的免疫机制如Treg细胞所抑制。因此,IL-23/IL-17信号通路可能是维持HBV病毒持续性感染的一个机制。     

Imbalance of Th17 cells and regulatory T cells in tuberculous pleural effusion

Both T helper interleukin 17 (IL-17)-producing cells (Th17 cells) and regulatory T cells (Tregs) have been found to be increased in human tuberculous pleural effusion (TPE); however, the possible interaction between Th17 cells and Tregs in TPE remains to be elucidated. The objective of the present study was to investigate the distribution of Th17 cells in relation to Tregs, as well as the mechanism of Tregs in regulating generation and differentiation of Th17 cells in TPE. In the present study, the numbers of Th17 cells and Tregs in TPE and blood were determined by flow cytometry. The regulation and mechanism of CD39⁺ Tregs on generation and differentiation of Th17 cells were explored. Our data demonstrated that the numbers of Th17 cells and CD39⁺ Tregs were both increased in TPE compared with blood. Th17 cell numbers were correlated negatively with Tregs in TPE but not in blood. When naïve CD4⁺ T cells were cultured with CD39⁺ Tregs, Th17 cell numbers decreased as CD39⁺ Treg numbers increased, and the addition of the anti-latency-associated peptide monoclonal antibody to the coculture reversed the inhibitory effect exerted by CD39⁺ Tregs. This study shows that Th17/Treg imbalance exists in TPE and that pleural CD39⁺ Tregs inhibit generation and differentiation of Th17 cells via a latency-associated peptide-dependent mechanism.     

Loss of the balance between CD4Foxp3 regulatory T cells and CD4IL17A Th17 cells in patients with type 1 diabetes

The presence of low-grade chronic inflammation is a known feature of long standing diabetes type 1. Recently, two T cell subsets, that may contribute to the disease progression are under investigation. These are Treg cells, which are specialized T cell subset, that controls the activity of autoreactive and inflammatory cells and Th17 cells which are involved in the pathogenesis of inflammatory and autoimmune diseases. The balance between Treg and Th17 controls inflammation and is responsible for the proper function of the immune system. An decrease of Tregs and/or increase of Th17 may induce local inflammation, which in turn may hasten the development of diabetic complications. In the present study, we have demonstrated that the Treg/Th17 balance was broken in patients with diabetes type 1 and might contribute to the progression of microvascular angiopathy.     

The deviated balance between regulatory T cell and Th17 in autoimmunity

Identifying the regulatory T cells (Tregs) and Th17 cells led to breaking the dichotomy of Th1/Th2 cells axis in immune responses involved in several autoimmune diseases. It is now well known that Tregs and Th17 cells are main orchestra leaders in pathogenesis symphony of autoimmunity. While Tregs are protective cells in autoimmune diseases, Th17 cells enhance the progression of autoimmune responses through induction of various pro-inflammatory reactions. It seems that the progression of autoimmunity may be associated with increase in Th17 and decrease in Treg levels, so that skewed balance between Tregs and Th17 toward Th17 is a phenomenon, which could be observed during progression of several autoimmune diseases. Although it is suggested that expansion and transfer of Tregs can be a new therapeutic target for autoimmune diseases, however, recent data about the phenotype conversion of Tregs into Th17 cells obligate us to more investigation on this approaching. Thus, identifying the new factors that induce stable phenotype in Tregs and prevent their phenotype conversion into Th17 cells as well as targeting the factor, which can modulate their balance, might be recommended as a new promising therapeutic method for autoimmune therapy. In this review, we try to clarify the factors, which can affect on this balance in various autoimmune diseases, as new targets in treatment of these diseases.     

The deviated balance between regulatory T cell and Th17 in autoimmunity

Identifying the regulatory T cells (Tregs) and Th17 cells led to breaking the dichotomy of Th1/Th2 cells axis in immune responses involved in several autoimmune diseases. It is now well known that Tregs and Th17 cells are main orchestra leaders in pathogenesis symphony of autoimmunity. While Tregs are protective cells in autoimmune diseases, Th17 cells enhance the progression of autoimmune responses through induction of various pro-inflammatory reactions. It seems that the progression of autoimmunity may be associated with increase in Th17 and decrease in Treg levels, so that skewed balance between Tregs and Th17 toward Th17 is a phenomenon, which could be observed during progression of several autoimmune diseases. Although it is suggested that expansion and transfer of Tregs can be a new therapeutic target for autoimmune diseases, however, recent data about the phenotype conversion of Tregs into Th17 cells obligate us to more investigation on this approaching. Thus, identifying the new factors that induce stable phenotype in Tregs and prevent their phenotype conversion into Th17 cells as well as targeting the factor, which can modulate their balance, might be recommended as a new promising therapeutic method for autoimmune therapy. In this review, we try to clarify the factors, which can affect on this balance in various autoimmune diseases, as new targets in treatment of these diseases.     

The imbalance of Th17/Th1/Tregs in patients with type 2 diabetes: relationship with metabolic factors and complications

Immune disorders are linked to the development of type 2 diabetes (T2D) and its complications. The relationship of CD4⁺CD25^hi T regulatory cells (Treg) and pro-inflammatory Th17 and Th1 subsets in T2D patients with metabolic disorders and complications need to be determined. The ratios of CD4⁺CD25^hi Treg/Th17 cells and CD4⁺CD25^hi Treg/Th1 cells, but not Th17/Th1 cells, were significantly decreased in T2D patients. The thymic output CD4⁺Foxp3⁺Helios⁺ Tregs were normal but peripheral induced CD4⁺Foxp3⁺Helios⁻ Tregs were decreased in T2D patients. The Bcl-2/Bax ratio decreased in CD4⁺CD25^hi Tregs in T2D patients, supporting the increased sensitivity to cell death of these cells in T2D. CD4⁺CD25^hiCD127⁻ Tregs in T2D patients with microvascular complications were significantly less than T2D patients with macrovascular complications. Importantly, CD4⁺CD25^hiCD127⁻ Tregs were positively correlated with plasma IL-6, whereas IL-17⁺CD4⁺cells were negatively related to high-density lipoprotein (HDL). Our data offered evidence for the skewed balance of anti- and pro-inflammatory T cell subsets in T2D patients and identified that HDL closely modulate T cell polarization. These results opened an alternative explanation for the substantial activation of immune cells as well as the development of T2D and complications, which may have significant impacts on the prevention and treatment of T2D patients.