KD 患儿Th17 / Treg 细胞失衡和单核细胞趋化蛋白1 的关系研究

目的:探讨川崎病(KD)患儿外周血CD4+ CD25+调节T 细胞(Treg) / 辅助性T 细胞17(Th17)与单核细胞趋化蛋白1(MCP-1)的关系及其在KD 发病中的作用机制。方法:2014 年6 月至2015 年6 月选取本院收治的48 例KD 患儿(恢复期28 例,急性期20 例)为研究对象,另选取40 例健康体检儿童为对照组,采用ELISA 法测定两组血清中白细胞介素-15,17,23(IL-15,17,23)及MCP-1 水平,采用流式细胞术测定两组外周血Treg/ Th17 细胞比例。结果:KD 组患儿血清IL-15、IL-17、IL-23 及MCP-1 水平显著高于对照组(P<0.05),且急性期KD 患儿血清IL-15、IL-17、IL-23 及MCP-1 水平高于稳定期组。KD 组患儿Treg 细胞、Treg/ Th17、Th17 显著高于对照组(P<0.05),急性期KD 患儿Treg 细胞、Treg/ Th17 水平、Th17 高于稳定期(P<0.05)。经Pearson 单因素分析,IL-15、IL-17、IL-23 及MCP-1 与Treg/ Th17 呈负相关(P<0.05)。结论:Treg 与Th17 细胞间的失衡及MCP-1 水平在KD 患儿体内持续升高可能与KD 病情发病及进展有密切的关系,通过测定KD 患儿Treg/ Th17 细胞比例及MCP-1 对评估患儿病情及预后具有一定的指导意义。

Relationship between Th17 / Treg cells and monocyte chemoattractant protein-1 in KD children

Objective:To investigate the relationship between CD4+ CD25+ regulatory T cells (Treg) and monocyte chemoat-tractant protein-1 and its mechanism in KD pathogenesis.Methods: 48 patients of KD (28 cases of recovery,20 cases of acute phase) were admitted from June 2014 to June 2015 and the other 40 cases of healthy children was admitted to control group.The levels of serum interleukin-15,17,23 (IL-15,17,23) and MCP-1 of two groups were measured with ELISA.The levels of Treg/ Th17 cell ratio of two groups were measured with flow cytometry.Results: The levels of IL-15,IL-17,IL-23 and MCP-1 of KD group were higher than control groups(P<0.05) and the levels of IL-15,IL-17,IL-23 and MCP-1 of acute phase groups were higher than recovery groups.The levels of Th17,Treg cells,Th17/ Treg of KD group were lower than the control group (P<0.05),while the levels of Th17,Treg cells,Th17/ Treg cells in the acute phase of KD patients were higher than stable phase.The levels of IL-15,IL-17,IL-23 and MCP-1 and Treg/ Th17 were negative correlation with univariate analysis by Pearson(P <0.05).Conclusion: The imbalance between Treg and Th17 cells and MCP-1 levels continue to rise may be associated with KD onset and progress of the disease is closely related to children in KD vivo by measuring children with KD Treg/ Th17 cells and MCP-1 ratio of assessment Children with the condition and prognosis has some signifycance.