胆道闭锁患儿外周血白细胞和肝组织免疫标志物表达谱与血清肝损伤指标的相关性

Correlation of the Expression Profile of Peripheral Leukocyte and Liver Tissue Immune Markers With Serum Liver Injury Indices in Children With Biliary Atresia.

作者信息

Helmin-Basa Anna, Kubiszewska Izabela, Trojanek Joanna B, Wiese-Szadkowska Małgorzata, Janowska Maria, Kułaga Zbigniew, Pawłowska Joanna, Michałkiewicz Jacek

机构信息

Department of Immunology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.

Department of Microbiology and Clinical Immunology, The Children's Memorial Health Institute, Warsaw, Poland.

出版信息

Mediators Inflamm. 2025 Apr 16;2025:9889239. doi: 10.1155/mi/9889239. eCollection 2025.

Abstract

The aim of the study was to find associations between the levels of liver injury serum markers and the selected liver, peripheral leukocytes, and plasma immune characteristics in biliary atresia (BA) children. Twenty-five newly diagnosed BA children aged 4-30 weeks and 12 age-matched controls were included (for leukocytes characteristics) and 19 BA children and 11 controls (for liver studies). The frequencies of T helper 1 (Th1), Th2, Th17, Th17.1 cells as well as numbers of regulatory T (Treg), B cell subsets, and matrix metalloproteinase -2 and -9 (MMP-2 and MMP-9) expressing leukocytes in the whole blood were evaluated by flow cytometry. Plasma concentrations of tissue inhibitors of metalloproteinase (TIMP)-1, -2, MMP-9, interleukin-17A (IL-17A) and IL-6 were assessed by enzyme-linked immunosorbent assay (ELISA). The leukocyte and liver expression of the retinoic acid receptor-related orphan nuclear receptor gamma (), fork-head winged helix transcription factor P3 (), transforming growth factor beta (), interleukin-17A (), , , , interleukin 1 receptor antagonist (, , , (liver only), , , T-box transcription factor expressed in T cells, also called TBX21 (), GATA-binding protein 3 (), and C-type lectin () mRNA were determined by real time RT-PCR (reverse-transcription polymerase chain reaction). The BA patients were characterized by increased frequencies of peripheral "suppressor" glycoprotein-A repetitions predominant protein (GARP)latency-associated peptide (LAP)Treg and activated Treg cells as well as MMP-2 and MMP-9 bearing lymphocytes, elevated plasma TIMP-1 levels, increased leukocyte expression of , , , , and , and decreased leukocyte expression of IL-21 and T-bet, increased liver expression of , , and decreased liver expression of and . The following correlations were found between serum markers of liver injury and leukocyte and liver immune characteristics: (a) hemoglobin (Hb) levels correlated negatively with frequency of peripheral "suppressor" GARPLAP Tregs; (b) aspartate aminotransferase (AST) levels correlated positively with frequency of the peripheral Th17.1 subset and expression of leukocyte , (c) gamma glutamyltransferase (GGT) levels correlated positively with the peripheral memory B cells frequencies, the leukocyte and gene expression, (d) alanine aminotransferase (ALT) serum levels correlated positively with the naïve B cell frequency and liver expression, (e) total bilirubin (Bil) levels correlated positively with the leukocyte , the plasma IL-6 levels, and the liver gene expression, (f) direct Bil levels positively correlated with the liver and expression, (g) international normalized ratio of prothrombin time (PT/INR) concentrations correlated positively with the peripheral Th17.1 subset frequency and the leukocyte but negatively with the liver expression. There were numerous strong positive correlations between the BA liver genes known to be involved in upregulation of IL-17 axis and MMPs/TIMPs expression. No prevailing leukocyte or liver single markers were uniquely associated with serum liver injury indices. BA immune profile is very complex with no single characteristics that would distinguish it from other liver inflammatory diseases.

摘要

本研究的目的是探寻胆汁闭锁(BA)患儿肝脏损伤血清标志物水平与所选肝脏、外周血白细胞及血浆免疫特征之间的关联。纳入了25例新诊断的4 - 30周龄BA患儿及12例年龄匹配的对照(用于白细胞特征研究),以及19例BA患儿和11例对照(用于肝脏研究)。通过流式细胞术评估全血中辅助性T细胞1(Th1)、Th2、Th17、Th17.1细胞的频率以及调节性T(Treg)细胞、B细胞亚群的数量,还有表达基质金属蛋白酶-2和-9(MMP-2和MMP-9)的白细胞数量。采用酶联免疫吸附测定(ELISA)法评估血浆中金属蛋白酶组织抑制剂(TIMP)-1、-2、MMP-9、白细胞介素-17A(IL-17A)和IL-6的浓度。通过实时逆转录聚合酶链反应(RT-PCR)测定视黄酸受体相关孤儿核受体γ(RORγt)、叉头翼状螺旋转录因子P3(Foxp3)、转化生长因子β(TGF-β)、白细胞介素-17A(IL-17A)、白细胞介素-21(IL-21)、白细胞介素-1受体拮抗剂(IL-1Ra)(仅肝脏)、T细胞中表达的T盒转录因子(T-bet)、GATA结合蛋白3(GATA-3)和C型凝集素(CLEC)mRNA在白细胞和肝脏中的表达。BA患者的特征为外周“抑制性”糖蛋白A重复序列优势蛋白(GARP)潜伏相关肽(LAP)Treg和活化Treg细胞以及携带MMP-2和MMP-9的淋巴细胞频率增加,血浆TIMP-1水平升高,白细胞中RORγt、Foxp3、TGF-β、IL-17A和IL-21的表达增加,白细胞中IL-21和T-bet的表达降低,肝脏中RORγt、IL-1Ra和TGF-β的表达增加,肝脏中Foxp3和T-bet的表达降低。在肝脏损伤血清标志物与白细胞及肝脏免疫特征之间发现了以下相关性:(a)血红蛋白(Hb)水平与外周“抑制性”GARPLAP Tregs频率呈负相关;(b)天冬氨酸转氨酶(AST)水平与外周Th17.1亚群频率及白细胞RORγt表达呈正相关;(c)γ-谷氨酰转移酶(GGT)水平与外周记忆B细胞频率、白细胞Foxp3和TGF-β基因表达呈正相关;(d)丙氨酸转氨酶(ALT)血清水平与幼稚B细胞频率及肝脏Foxp3表达呈正相关;(e)总胆红素(Bil)水平与白细胞RORγt、血浆IL-6水平及肝脏RORγt基因表达呈正相关;(f)直接胆红素水平与肝脏Foxp3和TGF-β表达呈正相关;(g)凝血酶原时间国际标准化比值(PT/INR)浓度与外周Th17.1亚群频率及白细胞RORγt呈正相关,但与肝脏Foxp3表达呈负相关。已知参与IL-17轴上调及MMPs/TIMPs表达的BA肝脏基因之间存在众多强正相关。没有单一的白细胞或肝脏标志物与血清肝脏损伤指标有独特关联。BA的免疫谱非常复杂,没有单一特征可将其与其他肝脏炎症性疾病区分开来。

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