Liang Zai, Jian Hong-Jian, Lin Qian-Yi, Luo Sai-Hua, Zhang Xiao-Peng
Department of Neurosurgery, Lianjiang Hospital Affiliated to Guangdong Medical University/Lianjiang People's Hospital, Lianjiang 524400, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Apr 20;37(4):546-550. doi: 10.3969/j.issn.1673-4254.2017.04.22.
To observe the dynamic changes of Th17/Treg balance in patients following surgical intervention for intracranial aneurysm rupture.
The percentage of Th cells and the intracellular IL-17 level, Treg cell percentage and transforming growth factor -β1 (TGF-β1) levels were examined in 73 patients with rupture of aneurysms before and at 24 h, 72 h and 1 week after operation, with 62 patients with unruptured aneurysms and 65 healthy volunteers as the control. The correlations among the immune cells, cytokines and clinical characteristics of the patients (NIHSS, ADL and hospitalization stay) were analyzed.
Th17 percentage and intracellular IL-17 levels were significantly higher in the patients with ruptured and unruptured aneurysms than in the healthy volunteers, and were significantly higher in patients with ruptured aneurysms than in those with unruptured aneurysms. Treg cell percentage and TGF-β1 level were significantly lower in patients with aneurysms than in the healthy volunteers, and were lower in patients with ruptured aneurysms than in those with uruptured aneurysms (P<0.05). Patients with intracranial aneurysm rupture showed significantly increased Th17 cell percentage and IL-17 level but significantly lowered Treg cell percentage and TGF-β1 at 24 h following the surgery (P<0.05); these changes were reversed significantly at 72 h and 1 week after the surgery. Th17 cell percentage and IL-17 level were positively correlated with NIHSS and the length of postoperative hospital stay but inversely correlated with ADL; Treg cell percentage and TGF-β1 were inversely correlated with NIHSS and hospital stay but positively with ADL (P<0.05).
In patients with intracranial aneurysms, the systemic immune inflammatory response is highlighted by excessive Th17 cells and insufficient Treg cells, which are closely related with the outcomes of the patients following surgical intervention. Evaluation of Th17/Treg balance and the cytokine levels can help to assess the prognosis of patients with aneurysm rupture.
观察颅内动脉瘤破裂患者手术干预后Th17/Treg平衡的动态变化。
检测73例动脉瘤破裂患者术前及术后24小时、72小时和1周时的Th细胞百分比及细胞内白细胞介素-17（IL-17）水平、调节性T细胞（Treg）百分比及转化生长因子-β1（TGF-β1）水平，以62例未破裂动脉瘤患者和65例健康志愿者作为对照。分析免疫细胞、细胞因子与患者临床特征（美国国立卫生研究院卒中量表[NIHSS]、日常生活活动能力量表[ADL]及住院时间）之间的相关性。
破裂和未破裂动脉瘤患者的Th17百分比及细胞内IL-17水平均显著高于健康志愿者，且破裂动脉瘤患者高于未破裂动脉瘤患者。动脉瘤患者的Treg细胞百分比及TGF-β1水平显著低于健康志愿者，且破裂动脉瘤患者低于未破裂动脉瘤患者（P<0.05）。颅内动脉瘤破裂患者术后24小时Th17细胞百分比及IL-17水平显著升高，但Treg细胞百分比及TGF-β1显著降低（P<0.05）；术后72小时和1周这些变化显著逆转。Th17细胞百分比及IL-17水平与NIHSS及术后住院时间呈正相关，但与ADL呈负相关；Treg细胞百分比及TGF-β1与NIHSS及住院时间呈负相关，但与ADL呈正相关（P<0.05）。
在颅内动脉瘤患者中，全身免疫炎症反应以Th17细胞过度和Treg细胞不足为特征，这与手术干预后患者的预后密切相关。评估Th17/Treg平衡及细胞因子水平有助于评估动脉瘤破裂患者的预后。
