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目的探讨辅助性T淋巴细胞17(Th17)和Foxp3+ CD4+调节性T淋巴细胞在儿童川崎病(KD)免疫发病机制中的作用。方法急性期KD患儿40例,同龄健康对照儿童30例。KD患儿在静脉丙种球蛋白(IVIG)治疗前直接取血备检。流式细胞术检测其外周血Th17细胞及Foxp3+ CD4+ T淋巴细胞比例;荧光定量PCR检测其CD4+T淋巴细胞转录因子RORγ-、tFoxp3 mRNA表达;ELISA法检测其血浆中IL-17、IL-6、转化生长因子-β(TGFβ-)、IL-23水平。结果急性期KD患儿外周血Th17细胞明显升高(P<0.01),而Foxp3+ CD4+ T淋巴细胞明显降低(P<0.01);急性期KD患儿Th17细胞转录因子RORγ-t转录水平明显高于健康对照组(P<0.01),Foxp3+ CD4+ T淋巴细胞转录因子Foxp3表达明显降低(P<0.01);血清IL-6、IL-23和IL-17水平明显升高(Pa<0.01),而TGFβ-水平无明显变化(P>0.05)。结论 Th17促炎性T淋巴细胞高表达和Foxp3+ CD4+调节性T淋巴细胞数量减少导致免疫抑制效应不足是导致儿童KD免疫失衡的重要原因,体内相关细胞因子的变化是引起上述改变的原因。
Objective To investigate the role of Th17 and Foxp3 + CD4 + regulatory T lymphocytes in the pathogenesis of childhood Kawasaki disease (KD). Methods Acute KD children 40 cases, the same age healthy control children 30 cases. KD children in the intravenous gamma globulin (IVIG) treatment before direct blood test. Flow cytometry was used to detect the ratio of Th17 cells and Foxp3 + CD4 + T lymphocytes in peripheral blood. Fluorescent quantitative PCR was used to detect the mRNA expression of RORγ- and tFoxp3. The levels of IL-17 and IL-6 , Transforming growth factor-β (TGFβ -) and IL-23 levels. Results Th17 cells in peripheral blood of KD patients were significantly increased (P <0.01) and Foxp3 + CD4 + T lymphocytes were significantly decreased in acute KD patients (P <0.01). The transcription level of RORγ-t in Th17 cells was significantly higher in children with acute KD The level of Foxp3 in Foxp3 + CD4 + T lymphocytes was significantly lower than that in healthy controls (P <0.01) (P <0.01). The levels of IL-6, IL-23 and IL-17 in serum were significantly increased - No significant change in level (P> 0.05). Conclusion The high expression of Th17 proinflammatory T lymphocytes and the decrease of Foxp3 + CD4 + regulatory T lymphocytes lead to the deficiency of immunosuppression, which is one of the important causes of KD immune imbalance in children. The changes of related cytokines in vivo are the causes of these changes.