文章摘要
赵小静,马晶晶,朱云娟,马海芹,张 怡,张红杰.克罗恩病患者外周血Th17/Treg细胞比例、血清炎性活动指标改变 及其临床意义[J].南京医科大学学报,2017,(8):1000~1004
克罗恩病患者外周血Th17/Treg细胞比例、血清炎性活动指标改变 及其临床意义
Alterations of Th17/Treg cells in peripheral blood and serum inflammatory biomarkers in patients with Crohn’s disease and its clinical significance
投稿时间:2016-12-13  
DOI:10.7655/NYDXBNS20170816
中文关键词: 克罗恩病  Th17/Treg细胞;血清炎性活动生物学指标
英文关键词: Crohn’s disease  Th17/Treg cells  serum inflammatory biomarkers
基金项目:国家自然科学基金(81470827)
作者单位
赵小静 南京医科大学第一附属医院消化科江苏 南京 210029 
马晶晶 南京医科大学第一附属医院消化科江苏 南京 210029 
朱云娟 南京医科大学第一附属医院消化科江苏 南京 210029 
马海芹 南京医科大学第一附属医院消化科江苏 南京 210029 
张 怡 南京医科大学第一附属医院消化科江苏 南京 210029 
张红杰 南京医科大学第一附属医院消化科江苏 南京 210029 
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中文摘要:
      目的:检测克罗恩病(Crohn’s disease, CD)患者外周血调节性T细胞(Treg)和辅助性T细胞17(Th17)细胞比例及血清炎性活动生物学指标血沉(ESR)、血清C-反应蛋白(CRP)水平、血小板(PLT)计数、平均血小板体积(MPV)、血小板分布宽度(PDW)的改变,并探讨其与CD疾病活动的关系及临床意义。方法:纳入CD患者46例,其中缓解期CD 31例,活动期15例。纳入同期病房收治的8例消化道息肉治疗后复查者作为对照组。采用克罗恩病疾病活动指数(CDAI)评估CD患者疾病活动严重程度。流式细胞仪检测CD患者外周血Treg、Th17细胞比例;血细胞仪检测PLT计数、MPV和PDW;魏氏法检测ESR;免疫比浊法检测CRP水平。结果:轻度和中度活动期CD患者外周血Treg细胞占CD4+细胞比例较缓解期CD患者及对照组显著降低(P<0.05);活动期CD患者外周血Th17细胞比例高于缓解期CD(P< 0.05);CD患者外周血中Treg细胞比例与ESR、血清CRP水平、CDAI评分呈负相关,而与患者MPV呈正相关(均P < 0.05)。结论:外周血Th17细胞和Treg细胞比例改变异常以及Treg细胞比例减低与反映CD疾病活动的炎性指标ESR、血清CRP水平呈负相关,提示Th17/Treg细胞失衡与CD肠道炎症形成有关。
英文摘要:
      Objective:The aim of our study is to investigate the alterations in frequency of regulatory T cells (Treg cells) and Thelper 17 (Th17) cells in peripheral blood in patients with Crohn’s disease (CD) and the relationship between the proportion of Treg cells and clinical features of CD. Methods: Forty-six patients with CD (31 quiescent and 15 active CD patients) were enrolled in our study. Eight cases who had gastrointestinal polyps treated and will have gastrointestinal endoscopy to check as normal controls. The disease activity of CD was evaluated by Crohn’s disease activity index (CDAI). Concurrently, blood platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) level were measured. The percentage of Treg and Th17 cells in peripheral blood from CD patients and control group were detected by flow cytometry. We also analyzed the relationship between the proportion of Treg cells and these inflammatory biomarkers. Results: In peripheral blood, the propotion of Treg cells in active CD patients was significantly decreased compared with patients in remission and control group (P < 0.05). Compared with quiescent CD patients, active CD patients had higher percentage of Th17 cells in peripheral blood (P< 0.05). ESR and serum CRP levels increased and MPV obviously decreased in active CD patients compared to quiescent patients. Negative correlation was found between proportion of Treg cells and ESR, serum CRP levels as well as CDAI (P < 0.05). In addition, there was a positive correlation between the proportion of Treg cells and MPV (P < 0.05). Conclusion: The change of proportion of Treg and Th17 cells in peripheral blood and the relationship between the proportion of peripheral Treg and serum inflammatory biomarkers reflecting CD activities (e.g., CRP, ESR and MPV) indicate that the differentiation imbalance of Th17/Treg may be involved in the pathogenesis of CD.
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