| Objective:To investigate the alteration of Th17 and Treg cells and their potential clinical significance on the immune evasion caused in patients with hepatic cystic echinococcosis. Meanwhile,to investigate the Th17/Treg imbalance and its clinical significance on immune evasion caused in patients with cystic echinococcosis. Methods:56 subjects who admitted to the first affiliated hospital of Xinjiang Medical University Digestive Vascular Department and Examination Center were enrolled and divided into three groups:Healthy control (HCE,N=20),Liver cystic echinococcosis (CE,n=21)and Recurrent cystic echinococcosis (RCE,n=15). The serum concentrations of Th17 cell related IL-17(Interleukin-17)and IL-23,Treg related TGF-β1 ( Transforming growth factor-β1 ) and IL-10 were measured by enzyme-linked immuno-sorbent assay (ELISA). The expressions of transcription factors ROR-γτand FoxP3 mRNA in peripheral mononuclear cells (Peripheral mononuclear cells,PBMC)in subjects were detected by real-time PCR. For statistical analysis,Student's t test and Pearson correlation were used. Results:Serum IL-17 concentrations were remarkably lower in CE(12.95 + 4.50)ng/L and RCE groups(13.35 + 3.46)ng/L compared with HC group(16.27 + 5.03)ng/L (F=3.265,P<0.05). However,there was no statistical significance between CE and RCE groups (t=0.22,P>0.05);IL-23 concentration was also lower CE(105.44 + 53.89)ng/L and RCE groups(100.64 + 48.32)ng/L compared with HC group(139.30 + 50.42)ng/L,(F=3.189,P<0.05),and no statistical significance between CE and RCE groups(t=0.02,P>0.05). However,IL-10 concentration was significantly higher in CE(4.31 + 2.00)ng/L and RCE(4.23 + 1.38)ng/L groups compared with HC group(3.08 + 0.82)ng/L,(F=4.087,P<0.01),and there was no statistical significance between CE and RCE groups(t=0.14,P>0.05);TGF-β1 concentration was also higher in CE(36.51 + 7.02)ng/ml and RCE groups(33.16 + 8.86)ng/ml compared with HC group(26.17 + 6.60)ng/ml (F=10.262,P<0.01),neverhteless no statistical significance found between CE and RCE groups (t=0.56,P>0.05). Th17/Treg (IL-17/IL-10)ratio significantly decreased in CE(3.58±1.52)and RCE(3.41±1.68)than in HC group(5.74 + 2.63)(F=13.76,P<0.01),whereas no statistical significance found between CE and RCE(t=0.234,P>0.05). The serum concentrations of IL-17 were positively correlated to IL-23(r=0.664,P<0.01).meanwhile,IL-10 concentrations were positively correlated with TGF-β1 concentration(r=0.344,P<0.01). Compared with HC groups(0.111 + 0.603),the expression of ROR-γτ(ROR-γτcopies / GAPDH copies)in CE (0.067 + 0.047)and RCE (0.059 + 0.056)were decreased (F=7.812,P<0.05). There were no statistical difference between CE and RCE groups (t=0.56,P>0.05). Oppositely,the expression of FoxP3 (FoxP3 copies / GAPDH copies)was increased in CE (0.007 + 0.005)and RCE (0.008 + 0.010)groups than that in HC group(0.006 + 0.005),but had no statistical difference(F=0.226,P>0.05). Compared with HC group(24.74 + 19.24),the ratio of ROR-γτand FoxP3 was obviously decreased in CE(12.64 + 7.59)and RCE(9.69 + 6.10)groups (F=7.179,P<0.01),but there was no difference between CE and RCE groups (t=0.48,P>0.05). Conclusions:Serum concentrations of IL-17 and IL-23 (Th17 cells related cytokines)and the expression of ROR-γτ(Th17cell specific transcription factor)in PBMCs were significantly lower in CE groups than that were in HC group;However,serum concentrations of IL-10 and TGF-β1 (Treg related cytokines)and the expression of FoxP3(Treg cells specific transcription factor)in PBMCs were highly elevated in CE than that were in HC groups. Treg overwhelmed Th17/Treg imbalance were observed in in patients with cystic echinococcosis. The Th17/Treg imbalance may one of the possible mechanisim that echinococcus granulosus used to actively modulate and suppress host immune system so that evade host's immune attacks for continuous survival.
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