Expression Of Th17 / Treg Cells In Peripheral Blood Of Patients With Rheumatoid Arthritis And Its Correlation With TCM Syndromes

Purpose:Our purpose is to study the expression of helper T cells (T helper cells, Th)17and regulatory T cells (regulatory T cells, Treg) in the Rheumatoid arthritis (RA) patients’ peripheral blood, and the correlation between their expression and TCM syndromes, and to provid e reference for the objective TCM differentiation.Methods:We chose RA patients who met the standard of the syndrome of cold-dampness blocking collaterals. the syndrome of dampness-heat blocking collaterals, the syndrome of intermingled phlegm and bloods tasis, the syndrome of long arthralgia and weakened body resistance,15cases for each group and15healthy volunteers, Used the method of flow cytometry (FCM) to detect the expressing rate of Th17and Treg cells, compared the differences between the results of RA patients and that of healthy volunteers, analyzed the relationship of these results with different course, disease activity and laboratory indicators, researched the proportional change of Th17/Treg cells of different RA TCM syndromes and the relationships of these resul ts with clinical indi cators. duration, disease activity, etc.Used statistical methods to analyze the correlations of all these results and TCM syndromes.Results:1.The comparison of Th17/Treg cells expression levels:Compared w ith the control group, the expression levels of Th17cells in RA pati ents’peripheral blood was significantly increased (P<0.01):and th e expression levels of Treg cells was significantly lower (P<0.01).2. The expression levels of Th17/Treg cells and the course:Compar ed the expression levels of Th17cells in early group (durat i on≤2yea rs) RA patients’peripheral blood to that in non-early group (durat ion>2years). there was no statistically significant difference (P>0.05). 3.The expression levels of Th17/Treg cells and the disease activi ty:Compared the expression levels of Th17cells in the DAS28≤5.1, n on-highly disease activity group RA patients’peripheral blood to th at in the DAS28>5.1, highly disease activity group, there was no sta tistically significant difference(P>0.05).4.The correlations of the expression levels of Th17/Treg cells an d the clinical indicators:There are positive correlations of the exp ression levels of Th17cells and the number of swollen joints, the nu mber of tenderness joints, the scores of DAS28, and the level of CRP in RA patients’peripheral blood (P<0.01orP<0.05); There is no corr elation of the expression levels of Treg cells and the number of swol len joints, the number of tenderness joints, the scores of VAS, the s cores of DAS28, the level of ESR, and the level of CRP in RA patients’ peripheral blood(P>0.05).5.The expression levels of Thl7/Treg cells and TCM syndromes:The expression levels of Th17cells in the syndrome of dampness-heat blo cking collaterals group RA patients’peripheral blood, is significan tly higher than that in the syndrome of cold-dampness blocking collat erals group,the syndrome of dampness-heat blocking collaterals group, the syndrome of intermingled phlegm and bloods tasis group, the syndr ome of long arthralgia and weakened body resistance group, and this d ifference is statistically significant (P<0.01). There is no statistic ally significant difference of the expression levels of Treg cells am ong all the syndromes(P>0.05).6.The correlations of TCM syndromes and the gender, the age, the duration:There is no statistically significant difference of the fou r syndromes in the gender, the age, the durat ion(P>0.05). 7.The relationships of the syndromes and the scores of DAS28, the swelling degree of joints, the tenderness degree of joints, the score s of VAS:There are statistically significant differences of the scor es of DAS28, the swelling degree of joints, the scores of VAS of RA p atients among all the syndromes (P<0.05. P<0.01, P<0.01). There is no statistically significant differences of the tenderness degree of joints (P>0.05). The swelling degree of joints, the scores of VAS are in descending order:the syndrome of dampness-heat blocking col later als group, the syndrome of cold-dampness blocking collaterals group, the syndrome of intermingled phlegm and bloods tasis group, the syndr ome of long arthralgia and weakened body resistance group, the tender ness degree of joints is in descending order:the syndrome of cold-da mpness blocking collaterals group, the syndrome of intermingled phleg m and bloods tasis group, the syndrome of dampness-heat blocking coll aterals group, the syndrome of long arthralgia and weakened body resi stance group.8.The relationships of TCM syndromes and the levels of ESR. of CR P, of RF, the morning stiffness time:There are statistically signifi cant differences of the levels of ESR. of CRP. and the morning stiffn ess time of the four syndromes, these three indicators in the syndrom e of dampness-heat blocking collaterals group are higher than other g roups (P<0.01, P<0.05, P<0.05):There is no statistically signific ant differences of the levels of RF among the syndromes(P>0.05):The levels of ESR, CRP, RF, and the morning stiffness of the four syndrom es are higher than the baseline value. Conclusion: 1. The expression of Th17cells in RA patients’ peripheral blood s ignificantly increased, the expression of Treg cells significantly de creased, and the percentage of Th17/Treg was significantly higher tha n that in healthy volunteers. The early group of RA compared with the non-early group, the highly active group compared with the non-highl y active group, the percentage of Th17/Treg of them are no significan t change: The imbalance of the percentage of Th17/Treg may be an impo rtant cause of RA, and the Th17may be a predominant cause.2. There are positive correlations of the expression levels of Thl7cells in RA patients’peripheral blood and the number of swollen j oints, the number of tenderness joints, the scores of DAS28, and the level of CRP; There is no correlation of the expression levels of Tre g cells in RA patients’peripheral blood and the number of swollen j oints, the number of tenderness joints, the scores of VAS, the scores of DAS28, the level of ESR, and the level of CRP.3. The expression of Th17cells in the syndrome of dampness-heat b locking collaterals group RA patients’ peripheral blood is significa ntly higher than that in other syndromes, which suggesting that the a utoimmune response of the syndrome of dampness-heat blocking col later als RA patients is more active than that of other syndromes.4. The swelling degree of joints, the scores of DAS28, the morning stiffness time, the levels of ESR and CRP, the scores of VAS of the syndrome of dampness-heat blocking collaterals group RA patients are significantly higher than that of other syndromes, which suggesting t hat the syndrome of dampness-heat blocking collaterals is closely ass ociated with RA disease activity. 5.The scores of VAS of the syndrome of cold-dampness blocking col laterals RA patients is significantly higher than that of other syndr omes, which suggesting that the subjective feeling of pain of the syn drome of cold-dampness blocking collaterals RA patients is stronger t han that of other syndromes.