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[肝硬化患者Th1与Th22细胞失衡的临床特征及其与疾病进展的关系]

[Clinical features of imbalance between Th1 and Th22 cells and its association with disease progression in patients with liver cirrhosis].

作者信息

Wu H Q, Zhao J J, Li H W, Zhang Z

机构信息

Peking University 302 Clinical Medical School, Beijing 100039 , China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2017 Oct 20;25(10):738-744. doi: 10.3760/cma.j.issn.1007-3418.2017.10.004.

Abstract

To investigate the clinical features of imbalance between Th1 and Th22 cells and its association with disease progression in patients with liver cirrhosis, and to explore immune therapeutic strategies for targeted therapy for liver cirrhosis. In vitro peripheral blood mononucleated cells (PBMCs) were collected by centrifugation. CD3-BV500 and CD8-PerCP-Cy5.5 staining was performed for these cells. IFNγ-PE-Cy7, IL-17a-APC, IL-22-PE, or the corresponding isotype control was added, and then PBMCs were fixed with 1% polyoxymethylene after being washed once by permeabilization-wash buffer. Flowjo software was used for the analysis of T lymphocyte subsets and cytokines. Th1 (CD4+IFNγ(+)), Th17 (CD4+IL-17a(+)), Th22 (CD4+IL-22(+)), Tc1 (CD8+IFNγ(+)), Tc17 (CD8+IL-17a(+)), and Tc22 (CD8+IL-22(+)) subsets were defined and the secretions of interferon-γ (IFN-γ), interleukin-17a (IL-17a), and interleukin-22 (IL-22) were measured for all subsets. LX-2 cells were cultured in a serum-free medium and different concentrations of recombinant human IL-22 protein (25, 50, 100 ng/ml) were added; 24 hours later, the activation marker α-smooth muscle actin (α-SMA) was used to measure LX-2 activation. Fetal bovine serum with a volume fraction of 10% was used as a positive control. Enzyme-linked immunosorbent assay (chemiluminescence) was used to measure the concentrations of hyaluronic acid, type III precollagen, and type IV collagen in supernatant. A one-way analysis of variance, the non-parametric Mann-Whitney U test, and the non-parametric Kruskal-wallis H test were used for statistical analysis based on data type. Compared with the health control group, the liver cirrhosis groups with various causes had significant increases in peripheral Tc1, Th17, and Th22 cells. The percentage of Th17 cells in the liver cirrhosis group was 1.64 times that in the control group (4.25%±2.45% vs 2.59%±1.36%, < 0.05), and the mean percentage of Th22 cells in the liver cirrhosis group was 2.18 times that in the control group (4.17%±2.55% vs 1.31%±0.64%, < 0.05). The percentages of Th17 (5.89%±3.44%) and Th22 cells (5.32%±3.67%) in the patients with alcoholic cirrhosis were 1.27 and 3.06 times those in the control group ( < 0.05). The patients with alcoholic cirrhosis had a significant increase in Th22 cells. The patients with different types of liver cirrhosis had a significant reduction in the ratio between anti-fibrotic and pro-fibrotic factors (Th1/Th22), which was positively correlated with the severity of liver cirrhosis and was a common immunological feature of liver cirrhosis with different causes. In addition, IL-22 activated hepatic stellate cells and promoted the production of collagen. The imbalance between anti-fibrotic and pro-fibrotic factors (Th1/Th22) is a common feature of the progression of liver fibrosis with various causes and may contribute to the progression of liver fibrosis.

摘要

探讨肝硬化患者Th1与Th22细胞失衡的临床特征及其与疾病进展的关系,探索针对肝硬化的免疫靶向治疗策略。体外通过离心收集外周血单个核细胞(PBMCs)。对这些细胞进行CD3-BV500和CD8-PerCP-Cy5.5染色。加入IFNγ-PE-Cy7、IL-17a-APC、IL-22-PE或相应的同型对照,然后用透化洗涤缓冲液洗涤一次后,用1%多聚甲醛固定PBMCs。使用Flowjo软件分析T淋巴细胞亚群和细胞因子。定义Th1(CD4+IFNγ(+))、Th17(CD4+IL-17a(+))、Th22(CD4+IL-22(+))、Tc1(CD8+IFNγ(+))、Tc17(CD8+IL-17a(+))和Tc22(CD8+IL-22(+))亚群,并测量所有亚群中干扰素-γ(IFN-γ)、白细胞介素-17a(IL-17a)和白细胞介素-22(IL-)的分泌。将LX-2细胞培养在无血清培养基中,加入不同浓度的重组人IL-22蛋白(25、50、100 ng/ml);24小时后,用活化标志物α-平滑肌肌动蛋白(α-SMA)测量LX-2的活化情况。用体积分数为10%的胎牛血清作为阳性对照。采用酶联免疫吸附测定(化学发光法)测量上清液中透明质酸、Ⅲ型前胶原和Ⅳ型胶原的浓度。根据数据类型,采用单因素方差分析、非参数Mann-Whitney U检验和非参数Kruskal-wallis H检验进行统计分析。与健康对照组相比,各病因肝硬化组外周血Tc1、Th17和Th22细胞均显著增加。肝硬化组Th17细胞百分比是对照组的1.64倍(4.25%±2.45% vs 2.59%±1.36%,<0.05),肝硬化组Th22细胞平均百分比是对照组的2.18倍(4.17%±2.55% vs 1.31%±0.64%,<0.05)。酒精性肝硬化患者Th17(5.89%±3.44%)和Th22细胞(5.32%±3.67%)百分比分别是对照组的1.27倍和3.06倍(<0.05)。酒精性肝硬化患者Th22细胞显著增加。不同类型肝硬化患者抗纤维化与促纤维化因子比值(Th1/Th22)显著降低,与肝硬化严重程度呈正相关,是不同病因肝硬化的共同免疫特征。此外,IL-22激活肝星状细胞并促进胶原蛋白的产生。抗纤维化与促纤维化因子失衡(Th1/Th22)是各种病因肝纤维化进展的共同特征,可能促进肝纤维化进展。

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