The Differentiation Of Th1/Th17/Treg Cells And Their Expression Of Associated Transcription Factors And Cytokines In Patients With Ankylosing Spondylitis

Objective: To investigate Th1/Th17/Treg differentiation and transcription factorsand cytokines expression of in patients with ankylosing spondylitis (AS), in order tofurther reveal the role of Th1/Th17/Treg cells in the pathogenesis of ankylosingspondylitis.Methods: The total50AS patients were selected according to New York Criteriarevised in1984, and were divided into stable condition group (24patients,ASDAS<2.1) and disease activity group (26patients, ASDAS≥2.1) by diseaseactivity.22individuals from physical examination were selected as healthy controlduring the same period. Peripheral blood were obtained from the AS patients and thehealthy volunteers. Th1and Th17lymphocytes were identified by the intracellulardetection of IFN-gamma and IL-17, respectively. Treg cells were identified byCD127-expression. The serum levels of related cytokine (IL-1β, IL-2, IL-6, IL-10,IL-17, IL-23, IFN-γ, TGF-β) were examined by enzyme linked immunosorbent assay(ELISA). The mRNA expression levels of RORC, FoxP3and T-bet were evaluated byquantitative real time PCR(RT-PCR). And analysis the relations in these statistics andbetween ASDAS. The results were analyzed by SPSS17.0. Software. Comparisonsbetween healthy volunteers and patients were performed by t tests and varianceanalysis; the multivariate analysis and linear correlation analysis were made onrepeated measurements. P≤0.05was considered statistically significant.Results: The percentage of Th1cells and Treg cells were lower in AS activitygroup than in AS stable group and the healthy controls, whereas the percentage ofTh17cells was higher. The serum levels of IL-1β，IL-6，IL-17and IL-23significantlyelevated in AS activity group as compared with stable condition group and healthycontrols. The mRNA level of RORC was significantly higher in AS patients, and the levels of T-bet and FoxP3were significantly lower. The ratio of T-bet mRNA/RORCmRNA and FoxP3mRNA/RORC mRNA changed significantly in AS activity group.The expression of T-bet mRNA in AS activity group was negatively correlated withRORC mRNA, and positively correlated with FoxP3mRNA, also positivelycorrelated in T-bet mRNA, RORC mRNA, FoxP3mRNA and ASDAS. The level ofcytokines, such as IL-17, IL-23, IL-10and TGF-β were closely paralleling withASDAS. There were significantly relations between IL-17and IL-23.Conclusion: There were higher level of Th17cells and their expression ofassociated transcription factors and cytokines and lower level of Th1cells, Treg cells,T-bet and FoxP3in the peripheral blood of AS patients. The imbalance of Treg/Th17and Th1/Th17exist are significantly related to AS.