| Background T helper cell(Th) 17 is a new type of CD4+T cell, which is distinct from Th1 and Th2 cells. There is a common conception recently that Th17 cell plays an important role in the pathogenesis and development of rheumatoid arthritis(RA) and systemic lupus erythematosus(SLE). Whereas debates about their particular change trend and their clinical significance still exist nowadays.Objective To detect the positive expression level of CD4+Thl7 cells in the peripheral blood of patients with RA and SLE, compare the disparities between them and ankylosing spondylitis(AS) and healthy people, analyze correlation between Th17 cells and disease activity, duration length, system damage, complications condition, auto antibody, and other clinical data and laboratory indicators, and realize their influences and effects on the diseases above-mentioned through their various functional status, as well as their clinical significance.Methods 36 RA patients, 20 SLE patients, and control goups (8 AS patients and 10 healthy volunteers gender and age matching) were collected in the Rheumatology and Immune Department of the First Affiliated Hospital of Anhui Medical University during February to May in the year of 2009. Meanwhile RA patients were divided into groups according to disease activity, bone erosion and secondary sjogren syndrome(SS). SLE patients were divided into groups according to disease activity, system damage and auto antibody. Extracted the peripheral blood mononuclear cell(PBMC), subsequently stimulated in vitro, fixed/rupture and intracellular dye. Flow cytometry(FCM) was used to detect IL-17+ expression in CD4+T cells.Results1. Peripheral Th17 lymphocytes increased in RA, SLE, AS patients compared with that in normal control(NC) group (2.99±1.51 vs 2.43±0.43 vs 1.93±1.29 vs 0.61±0.27, p<0.05). Meanwhile, those of RA are higher than of SLE. However, differences between RA and AS group had no statistical significance as well as those between AS and SLE group.2. Th17 cells show higher level in active group than in steady group of RA patients. Correlation existed not only between Th17 cells and some indicators of disease activity, for instance, swollen joint counts, tender joint counts, and visual analogue scale(VAS) of patients'pain degree assessment (p<0.05), but also between Th17 cells and the CCP antibody titers (p<0.05).3. Th17 cells appeared significant differences between bone-erosion group (n=27) and undamaged group (n=9), as well as secondary SS group (n=7) and no SS group of RA patients(3.30±1.57 vs 2.08±0.88, 4.62±0.24 vs 2.92±1.80,p<0.05). Compared with the early stage of RA course, Th17 increased not obviously in the non-early phase (3.09±1.59 vs 2.78±1.33,p>0.05). However, both are higher than those in NC group.4. Th17 cells revealed disparities between active (n=7) and inactive SLE group (n=13) (2.92±1.61 vs 1.39±0.69, p<0.05). 5. Th17 cells show positive correlation with 24 hours urine albumen(R=0.541), negative correlation with platelet(PLT) (r=-0.493) of SLE patients. Positive correlation also emerged between Th17 cells and anti-dsDNA antibody titers (r=0.638).Conclusion1. Th17 cells may be involved in the pathogenesis of RA and SLE, especially in the inflammatory arthropathy as RA.2. Th17 cells are associated with disease activity, bone erosion, occurance of secondary Sjogren's syndrome, and production of CCP antibodies in RA. Meanwhile, they may go up in active phase, put into effect during the whole disease course, and become an independent dangerous factor to induce bone erosion.3. Th17 cells are related in disease activity and patients'renal damage extent in SLE as well, and also impact on patients'hematological system (particularly PLT) and operation of anti-dsDNA antibodies.
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