To Investigate The Relationship Between Th9/Th22 Cells And Their Effectors And Clinical Symptoms In Patients With IBS-D

Objective:To investigate the proportions of Th9 cells,Th22 cells and their effectors(IL-9,IL-22)in blood and intestinal mucosa of IBS-D patients and the relationship with clinical symptoms.Methods:According to the Rome IV standard,Fifty patients were selected from the clinic or inpatient Department of Respiratory Medicine of The People’s Hospital of Guangxi Zhuang Autonomous Region,including 30 patients diagnosed IBS-D as the study group,20 patients were selected as the control group.Another We designed the questionaires collect general data of patients,abdominal pain,diarrhea and other intestinal symptoms.And detection of intracellular IL-9/IL-22 cytokine production to investigate Th9 and Th22 cells in thecolonic lamina propria and peripheral blood by flow cytometric.The proportion of Th1,Th2 and Th17 cells in CD4~+T lymphocytes in peripheral blood was determined by flow cytometry.The expression levels of interleukin(IL)-9 and interleukin(IL)-22 in serum were determined by enzyme-linked immunosorbent assay,and those in the intestinal mucosa were detected by immunohistochemistry.Results:(1)The proportions of Th9 and Th22 cells and the level of IL-22 were significantly higher in the intestinal mucosa of the study group than in that of the control group(P<0.05),whereas the IL-9 level showed no significant difference between the two groups(P>0.05).The percentages of Th9 and Th22 cells in the peripheral blood and plasma were not significantly different between the study group(IBS-D)and control groups(P>0.05).the number of Th17 cells in peripheral blood of study group was higher than that of the control group(P<0.05).The percentages of Th1 and Th2 cells in the peripheral blood were not significantly different between the study group and control groups(P>0.05).(2)The proportions of Th9 were positively correlated with Th22 cells in the intestinal mucosa positively.(3)The proportions of Th9 and Th22 cells in the intestinal mucosa positively correlated with the IBS-severity rating system and abdominal pain,loose stool in patients with IBS-D(P<0.05).(4)The areas under ROC curve of IBS-D diagnosed by the Th9 cell ratio,Th22 cell ratio and IL-22 level in the intestinal mucosa were 0.773,0.893 and 0.839,respectively,with corresponding sensitivity of 66.3%,86.7%and 83.3%and specificity of85.0%,80.0%and 75.0%.Conclusion:(1)The proportions of Th9 and Th22 cells in the intestinal mucosa of patients with IBS-D significantly increased,two cells were positively correlated;and these parameters were closely related to abdominal pain,diarrhoea and other symptoms of IBS-D patients and thus they may be involved in the occurrence and development of IBS-D.(2)Th9/Th22 cells and their effectors have no significant changes in peripheral blood of IBS-D patients,and there was no obvious correlation with the clinical characteristics of IBS-D patients.Peripheral and intestinal parts may have different immune status.