Relationship Between Th17Cell And Aplastic Anemia Pathogenesis In Children

Objective:To explore the significance of Th17cell in the process in children with aplastic anemia by detecting the transcription factor RORγt and IL-17expression of Th17cells in children with aplastic anemia at different stages. To find a new laboratory indicator for the diagnosis and evolution prognosis in children with aplastic anemia.Method:The expression of ROR γ t and Foxp3was examined by real-time quantitative polymerase chain reaction(RT-PCR)in bone marrow mononuclear cells collected from30newly diagnosed AA patients(SAA17cases, CAA13cases),20patients with effective immunosuppressive therapy (SAA12cases, CAA10cases). The concentration of IL-17, TGF-β,IL-10in the plasma was determined with enzyme-linked immunosorbent assay(ELISA) from20newly diagnosed AA patients (SAA12cases, CAA8cases),37patients with effective immunosuppressive therapy (SAA19cases, CAA18cases) and9patients with ineffective treatment (SAA6cases, CAA3cases)Results:(1) The expression of RORγt of the newly diagnosed SAA and CAA groups were higher than the control group (392.99±423.22),(143.58±86.61),(54.64±27.62)×10-3,(P<0.05), and the SAA effective treatment group (69.24±42.38)×10-3was lower than the newly diagnosed group(P<0.05),but the CAA effective treatment group (89.83±68.77)×10-3had no significant with the newly diagnosed group (P=0.107).The concentration of IL-17from newly diagnosed SAA and CAA groups were both higher than the control group (10.81±2.75),(11.95±3.69),(3.68±1.08) ng/L,(P<0.05); newly diagnosed SAA and CAA group had no significant (P>0.05); the concentration of IL-17of the SAA and CAA ineffective treatment groups were higher than the SAA and CAA effective treatment groups(9.34±3.14),(6.96±3.71),(6.74±2.82),(6.08±2.74),(P<0.05);the concentration of IL-17of the effective treatment groups were lower than the newly diagnosed but still higher than the control group(P<0.05).(2) The expression of Foxp3of the newly diagnosed SAA and CAA groups were lower than the control group (107.65±88.71),(76.54±51.70),(271.29±146.32)×10-3,(P<0.05), the expression of Foxp3of the effective treatment groups (246.98±150.05),(209.62±103.36)×10-3, were higher than the newly diagnosed(P<0.05),and had no significant with the control group (PS=0.628, PC=0.173). The concentration of TGF-β and IL-10from newly diagnosed SAA and CAA groups were both lower than the control group(446.95±166.99),(476.67±62.59),(643.35±87.37),(10.81±2.75),(11.95±3.69),(3.68±1.08) ng/L,(P<0.05); newly diagnosed SAA and CAA groups had no significant (P>0.05); the concentration of TGF-β and IL-10of the ineffective treatment groups were higher than the effective treatment group (516.53±133.01),(59.95±13.05),(458.19±137.24),(41.12±13.96)(616.38±104.77),(71.76±17.10),(619.31±116.39),(79.80±16.86) ng/L (P<0.05); the concentration of TGF-β and IL-10of the effective treatment groups were higher than the newly diagnosed but still lower than the control group(P<0.05).(3) There was a correlation between the expression of ROR Y t and the concentration of IL-17(r=0.667, P <0.01). There was a correlation between the expression of Foxp3and the concentration of TGF-β and IL-10(r=0.656, P<0.01; r=0.549, P<0.01)Conclusion (1)The expression of RORγ t and the concentration of IL-17in majority of AA patients significantly increased,and decreased in the effective treatment group,and there was a correlation between them.(2) The expression of Foxp3and the concentration of TGF-β,IL-10in majority of AA patients significantly decreased and increased in the effective treatment group,and there was also a correlation between them.(3) Th17cells and Treg cells could be valuable for monitoring the immune dysfunction and assessing the efficacy of immunosuppressive agents of AA.(4) treatment of Th17cells and Treg cells may be a new immune therapeutic strategies to treat AA.