手足口病患儿Th17、CD4+CD25+调节性T细胞的变化及意义

Changes in Th17 and CD4+CD25+ Treg cells and their significance among children with hand, foot and mouth disease

摘要:

目的 研究手足口病患儿外周血Th17、CD4⁺CD25⁺调节性T细胞（CD4⁺CD25⁺Treg）的变化。方法 以89例手足口病患儿为研究对象，其中普通型55例，重型34例，另选取30例健康儿童为对照组；采用流式细胞术检测各组外周血CD4⁺CD25⁺Treg细胞、Th17细胞在CD4+T淋巴细胞中所占的比例；采用ELISA法检测IL-10、TGF-β和IL-17在各组的表达水平。结果 与对照组相比，重型和普通型手足口病患儿的Th17细胞、IL-17水平均明显升高（均P<0.05），而CD4⁺CD25⁺Treg细胞、IL-10、TGF-β水平则显著下降（均P<0.05），且手足口病患儿外周血Th17、IL-17水平随病情严重而增高，而CD4⁺CD25⁺Treg细胞、IL-10、TGF-β水平随病情严重而降低。结论 手足口病患儿外周血Th17细胞应答增强，而CD4⁺CD25⁺Treg细胞应答降低，Th17细胞与CD4⁺CD25⁺Treg细胞比例失衡可能在手足口病发病机制中具有重要作用。

Abstract:

Objective To investigate the changes in peripheral blood Th17 and CD4⁺CD25⁺ regulatory T (Treg) cells and their significance among children with hand, foot and mouth disease (HFMD). Methods Eighty-nine children with HFMD, including 55 cases of common HFMD and 34 cases of severe HFMD, were included in the study; and 30 healthy children were selected as the control group. The percentages of Th17 and CD4⁺CD25⁺ Treg cells in CD4+ T cells in peripheral blood were determined by flow cytometry. The expression levels of interleukin (IL)-10, transforming growth factor-β (TGF-β), and IL-17 were measured by enzyme-linked immunosorbent assay. Results Compared with the control group, the cases of common HFMD and severe HFMD had significantly increased levels of Th17 cells and IL-17 (P<0.05) but significantly decreased levels of CD4⁺CD25⁺ Treg cells, IL-10, and TGF-β (P<0.05). The severity of the HFMD was positively correlated with the levels of Th17 cells and IL-17 in peripheral blood but negatively correlated with the levels of CD4⁺CD25⁺ Treg cells, IL-10, and TGF-β. Conclusions Children with HFMD have increased response of Th17 cells but decreased response of CD4⁺CD25⁺ Treg cells in peripheral blood. Th17/CD4⁺CD25⁺ Treg cell imbalance may play an important role in the pathogenesis of HFMD.