UNASSIGNED:为了确定T辅助细胞17(Th17)/调节性T(Treg)的免疫平衡是否与特发性腹膜后纤维化(IRPF)的发病机理有关,我们分析了外周血淋巴细胞的差异,阐明IRPF患者与健康人之间的CD4+T细胞亚群和细胞因子,尤其是Treg细胞亚群,以及细胞因子在IRPF发病机制中的作用。
未经证实:本研究纳入了22例IRPF患者,36例IgG4相关疾病(IgG4-RD)无腹膜后纤维化(RPF),和28个健康对照。流式细胞术检测各组外周血淋巴细胞亚群和CD4+T细胞亚群的绝对数量和百分比,流式细胞仪检测血清细胞因子水平。
UNASSIGNED:与健康组相比,IRPF患者外周血B细胞绝对值显著下降,T,自然杀手(NK),CD4+和CD8+均无显著异常。Th2细胞的绝对数量低于健康组(p=0.043)。特别是,Treg细胞的绝对数量明显低于健康组(p<0.001),Th17细胞的绝对数量增加(p=0.682)。Th17/Treg显著高于健康组(p<0.001)。细胞因子分析显示,IRPF患者白细胞介素(IL)-4水平高于健康组(p=0.011),IL-6、IL-10、IL-17、TNF-α和IFN-γ均显著高于健康组(均p<0.001)。受试者工作特征(ROC)曲线显示,IL-10和TNF-α可以区分IRPF患者的双侧输尿管扩张。ROC曲线下面积(AUC)为0.813(95%CI:0.607-1.000,p=0.026)和0.950(95%CI:0.856-1.000,p=0.001),分别。IL-6可以区分双侧输尿管梗阻,AUC为0.861(95%CI:0.682-1.000,p=0.015)。
未经证实:我们的研究表明,IRPF患者的Treg细胞减少,确实有Th17/Treg失衡,这可能与疾病的发病机制有关。IL-6,IL-10和TNF-α的水平似乎与IRPF的进展有关。
In order to determine whether the immune balance of T helper 17(Th17)/regulatory T(Treg) is related to the pathogenesis of idiopathic retroperitoneal fibrosis (IRPF), we analyzed the differences in peripheral blood lymphocytes, CD4+T cell subsets and cytokines between patients with IRPF and healthy people to clarify the CD4+T cell subsets, especially Treg cell subsets, and the role of cytokines in the pathogenesis of IRPF.
This study included 22 patients with IRPF, 36 patients with IgG4-related diseases (IgG4-RD) without retroperitoneal fibrosis (RPF), and 28 healthy controls. The absolute numbers and percentage of peripheral blood lymphocyte subsets and CD4+T cell subsets in each group were detected by flow cytometry, and the serum cytokine level was detected by flow cytometric bead array (CBA).
Compared with the healthy group, the absolute value of B cells in peripheral blood of IRPF patients was significantly decreased, and T, natural killer (NK), CD4+ and CD8+ were not significantly abnormal. The absolute numbers of Th2 cells were lower than healthy group(p=0.043). In particular, the absolute numbers of Treg cells were significantly lower than healthy group(p<0.001), while the absolute numbers of Th17 cells increased(p=0.682). Th17/Treg was significantly higher than healthy group (p< 0.001). Cytokine analysis showed that the level of interleukin (IL)-4 in IRPF patients was higher than healthy group(p=0.011), IL-6, IL-10, IL-17, TNF-α and IFN-γ were significantly higher than healthy group (all p<0.001). Receiver operating characteristic (ROC) curves showed that IL-10 and TNF-α could distinguish bilateral ureteral dilatation in IRPF patients, with areas under the ROC curve (AUCs) of 0.813 (95% CI:0.607-1.000, p=0.026) and 0.950 (95% CI:0.856-1.000, p=0.001), respectively. IL-6 could distinguish bilateral ureteral obstruction, with an AUC of 0.861 (95% CI: 0.682-1.000, p=0.015).
Our study showed that IRPF patients had reduced Treg cells and indeed had Th17/Treg imbalance, which may be related to the pathogenesis of the disease. The levels of IL-6, IL-10 and TNF-α appear to be associated with the progression of IRPF.