Change Of Immune Index In Refractory RAU And Thalidomide Treatment Effect On Its Immune Level

Chapter 1The change of peripheral blood immunoglobulins and complements in refractory recurrent aphthous ulcer[Objective]To observe the alteration of peripheral blood immunoglobulin and complement levels in RAU patients,and to compare the difference between refractory RAU and general RAU in order to provide experimental basis for exploring the pathogenesis of RAU.[Methods]We collected 329 refractory RAU,296 general RAU patients and selected 217 volunteers as healthy control group.Immunoglobulins and complements(IgG,IgA,IgM,C3 and C4)were assessed by immuneturbidimetry.The value of delta A based on the multi-point calibration concentration was the corresponding absorbance change,using nonlinear calibration method of log(4P)to determinethe working curve,in which the concentration corresponding to the change of absorbance of measured sample was eaqual to the concentration of Ig and C..IgE was assayed by Electrochemiluminescence,and the data were automatically extracted from the standard curve.The data were analyzed by SPSS 18.0,while P-value less than 0.05 was considered significant.[Results]Levels of immunoglobulins(IgG,IgA,IgM,IgE)and complements(C3,C4)increased in RAU group.Compared with health control,refractory RAU and general RAU group showed respectively IgG,IgA and IgE increased(P<0.01),C3 and C4 increased(P<0.05).Compared with health control,IgG,IgA,IgE,C4 and C3 increased(P<0.01)in refractory RAU.However,compared with health control,the levels of immunoglobulins showed no significant difference in general RAU(P>0.05),C3 and C4 were increased(P<0.01,P<0.05).[Conclusions]The levels of immunoglobulins and complements in RAU patients have increased,and that of immunoglobulin in refractory RAU patients increased more significantly.Chapter 2The change of peripheral blood lymphocyte subsets proportion in refractory recurrent aphthous ulcer[Objective]To analyze lymphocyte subsets composition in patients with RAU,and study lymphocyte subsets composition respectively in refractory RAU,general RAU and the health control in order to provide the experimental basis for exploring the pathogenesis of RAU.[Methods]We collected 329 refractory RAU patients,296 general RAU patients and 217 patients for health control.Lymphocyte subsets(CD19+,CD3+,CD4+,CD8+,NK)were examined by flow cytometry and mode data acquisition and analysis was listed using the BD CellQuest Pro software.[Results]In RAU group,the proportion of CD4+ T cells and CD4+/CD8+ decreased,and CD8+ T cells and NK cells increased(P<0.01).Compared with general RAU,CD19+and CD4+/CD8+ of refractory RAU decreased,the proportion of CD8+ T cells increased(P<0.01).Compared with health control,CD19+,CD4+ T and CD4+/CD8+decreased with CD8+ T increasing(P<0.01).The proportion of CD3+ cells and NK cells increased(P<0.05)in refractory RAU.Compared with health control,the proportion of CD4+ T cells decreased(P<0.05)in general RAU.[Conclusions]The composition of RAU lymphocyte subsets unbalanced.The amplitude of cellular immunity in patients with refractory RAU were larger.Chapter 3Thalidomide treatment effect on ulcer immune level in refractory recurrent aphthous[Objective]Based on the short-term clinical study on thalidomide treatment given to refractory RAU and the determination of peripheral blood immune index before and after thalidomide treatment of refractory RAU.[Methods]We selected 80 refractory RAU patients and 80 volunteers for health control to observe the clinical effect of thalidomide on refractory RAU in the period of 1-month treatment and 2-month ensuing withdrawal.Levels of peripheral blood immunoglobulins,complements and lymphocyte subsets proportions were determined respectively with immune turbidimetry,electrochemiluminescence assay and flow cytometry by thalidomide treatment on refractory RAU after 1 months.Data was analyzed by SPSS 18 statistical software.[Results]By thalidomide treatment on refractory RAU 1 months and 2 months after the treatment,the intermittent duration prolonged,the healing time,the number of ulcer and VAS were decreased after 1 months(P<0.05)but the disease had a relapse tendency after 2 months of withdrawal for thalidomide.At the same time,the levels of IgG,IgA,C3 and C4 were decreased and the percentage of CD4+ T cells in lymphocyte subsets was increased after 1 months of the treatment(P<0.05).[Conclusions]The results show the obvious effect of thalidomide in the treatment of refractory RAU.Thalidomide having an effect on the immune levels of refractory RAU patients can regulate humoral and cellular immune function which may be one of its mechanism on the treatament of refractory RAU.