The Study Of Th17 Cells,Treg Cells And Breg Cells In The Pathogenesis Of Childhood Immune Thrombocytopenia

BackgroundImmune thrombocytopenia(ITP)is an autoimmune disease characterized by increased destruction of platelets,decreased production,and decreased platelet counts.Most studies have shown that the pathogenesis of ITP involves humoral immunity and cellular immunity,but its specific pathogenesis is currently not fully clear,especially the cellular immune mechanism.With the in-depth research on the pathogenesis of ITP,it has been found that T cell subsets Th17 cells,Treg cells and B cell subgroups Breg cells may also participate in the pathogenesis of ITP.However,the current domestic and foreign studies on the role of Th17 cells,Treg cells,and Breg cells in the pathogenesis of ITP are still unclear,and the mechanism of Th17/Treg imbalance is also unclear.ObjectiveTo explore the role of Th17 cells,Treg cells and Breg cells in the pathogenesis of ITP;Analyze the correlation between Breg cells and Th17 cells,Treg cells,Th17/Treg ratio,and to explore whether Breg cells participate in the mechanism of Th17/Treg imbalance.Methods1.SubjectsAccording to the diagnostic criteria for children’s ITP,24 newly diagnosed children with ITP who were admitted to the First Affiliated Hospital of Xinxiang Medical University from August 2019 to August 2020 were selected as the experimental group.In addition,21 children who had the same age and sex as the outpatient physical examination in this hospital during the same period were selected.A healthy child served as a control group.2.Detect the level of Th17 cells,Treg cells,and Breg cellsUnder aseptic operation,collect 2 ml of peripheral venous blood from the two groups of subjects,place them in an EDTA anticoagulation tube,mix gently,and then take the anticoagulated blood separately,and use Dx FLEX flow cytometer to detect Th17 cells,Treg cells,and Breg cells,and calculate the ratio of Th17/Treg;use XN-2000 automatic blood cell analyzer to detect the level of platelet;solid phase agglutination method was used to detect platelet antibodies in the experimental group.3.Statistical processingSPSS22.0 statistical software was used for data analysis.Measurement data were expressed as mean±standard deviation(?χ?s).Two independent sample t-tests were used for comparison between groups,and count data were subjected toχ~2 test.The correlation between Breg cells and Th17 cells,Treg cells,Th17/Treg was analyzed by Pearson correlation analysis;P<0.05 was considered statistically significant.Results1.Comparison of age and gender between the experimental group and the control groupThere were 24 cases in the experimental group,13 males and 11 females,with an average age of(42.2±32.4)months;21 cases in the control group,15 males and 6 females,with an average age of(43.0±39.8)months;There was no statistical difference between the two groups(P>0.05).2.Blood routine results of experimental group and control groupThere is no significant difference in the levels of white blood cells,red blood cells and hemoglobin between the experimental group and the control group(P>0.05);compared with the control group,the platelet count of the experimental group was significantly reduced.The platelet counts of the two groups were(14.79±9.82)×10~9/L,(356.00±88.48)×10~9/L,the difference was statistically significant(P<0.05).3.Comparison of Th17 cells,Treg cells,Th17/Treg ratio and Breg cells levels between the experimental group and the control groupThe levels of Th17 cells in the experimental group and the control group were(7.91±3.26)%and(3.42±1.74)%respectively;the levels of Treg cells were(6.93±1.79)%and(8.03±1.14)%respectively;the levels of Th17/Treg ratios were 1.25±0.70 and0.43±0.22 respectively;the levels of Breg cells were(3.04±2.02)%and(6.59±1.74)%respectively.The Th17 cells levels and Th17/Treg ratio of the experimental group were higher than those of the control group,and the differences were statistically significant(t=5.642,5.466,P<0.05).The levels of Treg cells and Breg cells in the experimental group were lower than those in the control group,and the differences were statistically significant(t=-2.475,-6.261,P<0.05).4.Correlation analysis of Breg cells,Th17 cells,Treg cells,Th17/Treg ratio in the experimental groupPearson correlation analysis showed that there was no significant correlation between Breg cells and Th17 cells,Treg cells,Th17/Treg ratio in the experimental group(r=-0.001,-0.260,-0.097,P>0.05).5.Correlation analysis of Th17 cells,Treg cells,Breg cells and platelet counts in the experimental groupPearson correlation analysis showed that there was no significant correlation between the levels of Th17 cells,Treg cells,Breg cells and platelet counts in the experimental group(r=0.140,-0.185,0.004,P>0.05).6.Comparison of Th17 cells,Treg cells and Breg cells levels between platelet antibody positive group and negative groupThe levels of Th17 cells in peripheral blood of children in the platelet antibody-positive group and platelet antibody-negative group were(9.58±3.31)% and (7.08±3.00)%respectively;the Treg cells levels were(7.44±1.96)%and(6.68±1.71)%respectively;Breg cells levels were(2.48±0.60)% and (3.33±2.41)% respectively.There was no significant difference in the levels of Th17 cells,Treg cells and Breg cells in the peripheral blood of children in the platelet antibody-positive group and the platelet antibody-negative group(t=1.860,0.989,-0.971,P>0.05).Conclusion1.There is cellular immune disorder in newly diagnosed children with ITP,Th17cells,Treg cells and Breg cells are involved in the pathogenesis of ITP;2.There is an imbalance of Th17/Treg ratio in children with ITP,and Th17 cells are dominant;no relationship between Breg cells and Th17/Treg imbalance is found.