再生障碍性贫血患儿外周血Tre g／Th 17细胞失衡的研究

目的：探讨CD4＋CD25＋调节性T细胞（Treg）/Th17细胞失衡在儿童再生障碍性贫血（AA）发病中的意义。方法采用流式细胞仪（FCM）检测AA患儿和健康对照组儿童外周血Treg细胞和Th17细胞的比例，酶联免疫吸附法（ELISA）检测血浆中IL-17和IL-6的水平。结果 AA患儿外周血Th17细胞比例（1.45±0.28）％显著高于同龄对照组（0.45±0.10）％（P＜0.01），而Treg细胞比例（4.05±1.07）％及 Treg/Th17细胞比值（2.89±0.88）明显低于同龄对照组儿童（6.96±0.79）％、（15.77±2.77）（P＜0.01）。AA患儿血浆中IL-17、IL-6水平分别为（185.96±40.42）、（20.78±5.49）pg/mL，显著高于同龄对照组（120.47±18.39）、（10.44±2.51）pg/mL （P＜0.01），且IL-17和IL-6水平均与Th17细胞比例呈正相关（r＝0.67，P＜0.01；r＝0.57，P＜0.01），而Treg细胞比例与IL-6水平呈负相关（r＝-0.39，P＜0.05）。结论 AA患儿Treg细胞比例的减低和Th17细胞比例的增加所致的Treg/Th17细胞失衡，可能在儿童再障发病中起重要作用，IL-6高表达可能是导致Tre g/Th 17细胞失衡的原因之一。

Study on the imbalance of peripheral blood Treg/Th17 cells in childhood aplastic anemia

Objective To investigate the role and clinical significance of Treg /Th17 cell imbalance in pathogenesis of childhood aplastic anemia.Methods The flow cytometry was used to evaluate the proportion of peripheral blood Treg cells and Th17 cells in childhood aplastic anemia and healthy children.The levels of plasma IL-17 and IL-6 were assayed by enzyme-linked immunosorbent assay（ELISA）.Results The percentage of peripheral blood Th17 cells was increased significantly in aplastic anemia children compared with healthy controls （1.45 ±0.28）% vs （0.45 ±0.10）%]（P〈0.01）,while the percentage of Treg cells and the ratio of Treg/Th17 was markedly lower（4.05 ± 1.07）% vs （6.96 ±0.79）%;（2.89 ±0.88）vs（15.77 ±2.77）]（P〈0.01）.The levels of plasma IL-17 and IL-6 in childhood aplastic anemia were （185.96 ±40.42）pg/mL and（20.78 ±5.49）pg/mL, respectively,which were significantly increased compared with controls（120.47 ±18.39）pg/mL and （10.44 ±2.51 ）pg/mL]（P 〈0.01 ）.Furthermore,both plasma levels of IL-17 and IL-6 were positively correlated with the proportion of Th17 （r =0.67,P 〈0.01;r =0.57,P 〈0.01 ）,but the percentage of Treg cells had negative correlation with the plasma concentration of IL-6 （r=-0.39 ,P〈0.05）.Conclusions The imbalance between Treg cells and Th17 cells resulted from decreased ratio of Treg cells and increased ratio of Th17 cells,which may play a critical role in pathogenesis of childhood aplastic anemia,and the increase expression of IL-6 may be one of the factors causing the imbalance of Treg /Th17 cells.