Imunoregulatory Effects Of T Helper 17 Cells In The Immunorelated Pancytopenia

Immunorelated pancytopenia(IRP)involves in multiple clinical disciplines and is a major problem for clinicians.Scholars discover that IRP is a kind of cytopenia syndrome and such patients produce autoantibody against the bone marrow immature hematopoietic cells.The production of autoantibodies on bone marrow hematopoietic cells is due to the imbalance in T lymphocyte regulation resulting in abnormal quantity and function of B lymphocyte and its subset.They destroyed or inhibited the differentiation and maturation of bone marrow hematopoietic cells,leading to a reduction of peripheral blood cells eventually.Recent studies have shown that there is a new type of CD4+effector T cells unlike Thl and Th2 in body,That is T helper 17 cells which come from the differentiation of natural T cell and have independent regulatory mechanism of differentiation and development.Th17 cells mainly secrete cytokines to play his role,Now we have found cytokines:IL-17A、TNF-α、IL-17F、IL-6、IL-22、IL-21,etc,the most important is the IL-17,Th17 cells were named also because of its high IL-17 secretion.Study show that Th17 cells can regulate B lymphocytes and play an important role in multiple autoimmune diseases.The increasing number of T helper 17 cells and the hyperfunction of T helper 17 cells may be associated with the production of autoantibodies in patients with immunorelated pancytopenia,which is an important factor for the pathogenesis of immunorelated pancytopenia.Based on the above two points,this article seeks to study bone marrow early cell autoantibodies and the numbers and function of Th17 cell in IRP,to explore the risk factors and therapeutic targets for IRP.The author has collected 36 cases of patients with suspected IRP,while 22 cases of patients with bone marrow hematopoietic system failure and 22 cases of normal control since May 2012.Through research and statistics,The positive rate of suspected IRP patients is 88.88%,the patients with bone marrow hematopoietic system failure is 9.09%.The ratios of CD19+and CD5+B lymphocyte in peripheral blood were significant higher in diagnosed IRP than that in patients with bone marrow hematopoietic system failure and control group,while the ratios of those in control group were significant higher than that in patients with bone marrow hematopoietic system failure.The ratio of IL-23R+CD4+/CD4+cells were significant higher in diagnosed IRP than that in patients with bone marrow hematopoietic system failure,complete remission group and control group,and the levels of IL-6,IL-17,IL-23 were significant higher in diagnosed IRP than that in patients with bone marrow hematopoietic system failure,complete remission group and control group.The results indicated that the application of flow cytometry in detecting the autoantibodies of bone marrow cells and B-lymphocyte in peripheral blood can provide reliable diagnostic evidence,which is better than the bone marrow Coomb’s test.The increased amplification and expansion of Th17 cells mediated by IL-23 may be one of underlying causes of morbidity for IRP.Immune intervention therapy can significantly reduce the number of Th17 cells,inhibiting the Th17 cells may be a potential therapeutic target for IRP,which provide a strong theoretical basis for IRP.