Cheng Hai, Cao Jiang, Chen Wei, Qi Kun-Ming, Li Zhen-Yu, Xu Kai-Lin
Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China.
Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Feb;28(1):218-224. doi: 10.19746/j.cnki.issn.1009-2137.2020.01.037.
To study the level and clinical value of Th17 cell subset in the peripheral blood of the patients with aplastic anemia (AA).
Eighty-five patients with aplastic anemia in our hospital from May 2017 to February 2018 were selected. Among them, 51 patients with poor curative effect were enrolled in group A. and the 34 patients with good curative effect were enrolled in group B, the 35 healthy persons were selected as controls. The levels of serum IL-17, IL-6, IL-4 and IFN-β were analyzed by ELISA; the levels of peripheral blood Th17 cell subset were analyzed by flow cytometry; the expression levels of RORγt and STAT3 mRNA in lymphocytes were analyzed by RT-PCR; the expression levels of RORγt and STAT3 protein in lymphocytes were analyzed by Western blot.
There was no significant difference in sex, age, WBC count and complications between group A and group B (P＞0.05). Non-severe aplastic anemia (NSAA) in group B accounted for 23 cases, and the NSAA ratio (23/34) was significantly higher than that in group A (20/51) (P＜0.05). The Hb level (86.25±7.9 g/L) and Plt count (54.7 ± 6.3×10/L) in group B were significantly higher than those in group A (P＜0.05). ELISA showed that the levels of IL-17 and IL-6 in group A were significantly higher than those in control group (P＜0.05); the levels of IL-17 and IL-6 in group B were significantly lower than those in group A (P＜0.05); the levels of IL-4 and IFN-β in group A were significantly lower than those in control group (P＜0.05); the levels of IL-4 and IFN-βin group B were significantly higher than those in group A (P＜0.05). Flow cytometry showed that the proportion of Th17 cells in peripheral blood of group A was higher than that of group B (P＜0.05). RT-PCR showed that the levels of RORγt and STAT3 mRNA in group A were significantly higher than those in control group (P＜0.05), and the mRNA levels of RORγt and STAT3 in group B were significantly lower than those in group A (P＜0.05). Western blot showed that the protein levels of RORγt and STAT3 in group A were significantly higher than those in control group (P＜0.05), and the protein levels of RORγt and STAT3 in group B were significantly lower than those in group A (P＜0.05).
The Th17 cells in peripheral blood of AA patients increase, and the inflammatory reaction in the patients are enhanced. It may be related with the rise of RORγt and STAT3 gene expression, which provides a research direction for clinical treatment of AA.
研究再生障碍性贫血（AA）患者外周血中Th17细胞亚群水平及其临床价值。
选取2017年5月至2018年2月我院收治的85例再生障碍性贫血患者，其中疗效不佳的51例患者纳入A组，疗效良好的34例患者纳入B组，选取35例健康者作为对照组。采用酶联免疫吸附测定法（ELISA）分析血清白细胞介素-17（IL-17）、白细胞介素-6（IL-6）、白细胞介素-4（IL-4）及干扰素-β（IFN-β）水平；采用流式细胞术分析外周血Th17细胞亚群水平；采用逆转录-聚合酶链反应（RT-PCR）分析淋巴细胞中维甲酸相关孤儿受体γt（RORγt）和信号转导及转录激活因子3（STAT3）mRNA表达水平；采用蛋白质免疫印迹法（Western blot）分析淋巴细胞中RORγt和STAT3蛋白表达水平。
A组和B组患者在性别、年龄、白细胞计数及并发症方面比较，差异均无统计学意义（P＞0.05）。B组非重型再生障碍性贫血（NSAA）患者23例，NSAA占比（23/34）显著高于A组（20/51）（P＜0.05）。B组血红蛋白（Hb）水平（86.25±7.9 g/L）及血小板（Plt）计数（54.7±6.3×10/L）显著高于A组（P＜0.05）。ELISA检测显示，A组IL-17和IL-6水平显著高于对照组（P＜0.05）；B组IL-17和IL-6水平显著低于A组（P＜0.05）；A组IL-4和IFN-β水平显著低于对照组（P＜0.05）；B组IL-4和IFN-β水平显著高于A组（P＜0.05）。流式细胞术检测显示，A组外周血Th17细胞比例高于B组（P＜0.05）。RT-PCR检测显示，A组RORγt和STAT3 mRNA水平显著高于对照组（P＜0.05），B组RORγt和STAT3 mRNA水平显著低于A组（P＜0.05）。Western blot检测显示，A组RORγt和STAT3蛋白水平显著高于对照组（P＜0.05），B组RORγt和STAT3蛋白水平显著低于A组（P＜0.05）。
AA患者外周血Th17细胞增多，炎症反应增强，可能与RORγt和STAT3基因表达上调有关，为AA临床治疗提供了研究方向。
