Clinical significances of expressions of T helper cell 17, regulatory T cell and their cytokines in peripheral blood of children with severe pneumonia

doi:10.3877/cma.j.issn.1673-5250.2017.04.008

Objective

To study expression levels of T helper cell (Th) 17 and regulatory T cell (Treg) and their cytokines in peripheral blood of children with severe pneumonia, and their clinical significances.

Methods

From January 2013 to June 2015, a total of 52 children who were diagnosed as severe pneumonia in People′s Hospital Affiliated to Hubei University of Medicine were included in study group. A total of 30 healthy children who received health examination in the same hospital during the same period were included in control group. The ratios of Th17 and Treg in CD₄⁺ T, and Treg/Th17 in peripheral blood were measured by flow cytometry. The levels of serum interleukin (IL)-17, -6, -10 and transforming growth factor (TGF)-β in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA) of two groups. The ratios of Th17 and Treg in CD₄⁺ T, and Treg/Th17, and the levels of serum IL-17, -6, -10 and transforming growth factor (TGF)-β in peripheral blood between two groups were compared by statistical methods. This study was in line with the ethics standards promulgated by the Human Subjects Committee of People′s Hospital Affiliated to Hubei University of Medicine and approved by the committee, and obtained the informed consents from all the chlidren′s guardians.

Results

①The ratio of Th17 in CD₄⁺ T in peripheral blood of children with severe pneumonia in study group was 12.1%±3.0%, which was significantly higher than that of control group 8.5%±1.5%, and the difference was statistically significant (t=5.982, P<0.001). ②The ratio of Treg in CD₄⁺ T in peripheral blood of children with severe pneumonia in study group was 3.4%±0.1%, which was significantly lower than that of control group 8.7%±1.2%, and the difference was statistically significant (t=33.134, P<0.001). ③The Th17/Treg in peripheral blood in study group was 0.49±0.17, which was significantly lower than that in control group 0.23±0.08, and the difference was statistically significant (t=18.620, P<0.001). ④Compared with control group, the levels of serum IL-10 and TGF-β in peripheral blood of study group were significantly decreased, the levels of serum IL-17 and IL-6 were significantly increased, and all the differences were statistically significant (t= 36.758, 26.746, 34.312, 42.145; P<0.001).

Conclusions

The expression levels of Th17 and its related cytokines in peripheral blood of children with severe pneumonia are significantly increased, while the expression levels of Treg and its related cytokines are decreased, and the Th17/Treg is increased significantly, suggesting that Th17/Treg imbalance occurs in the pathogenesis and development of severe pneumonia and plays an important role. Th17/Treg balance test has a certain guiding significance for the clinical treatment of severe pneumonia.

Key words: Pneumonia, severe, Th17 cells, T-lymphocytes, regulatory, Cytokines, CD₄-positive T-lymphocytes, Child

图1 研究组和对照组外周血血清IL-17、-6、-10和TGF-β水平比较(图1A：IL-17　水平比较；图1B：IL-6　水平比较；图1C：IL-10　水平比较；图1D：TGF-β　水平比较)

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