Study On The Relationship Between The Expression Of IL-21 And Bcl-6 In Peripheral Blood And Clinical Of Eczema

Objective: Eczema is a chronic inflammatory skin disease with a diversity of skin lesions. Present studies showing that eczema is a kind of allergic disease with the T cells function disorder. It is also influenced by a variety of internal or external environmental factors and polygenic inheritance background. The existing domestic and foreign literature indicates that follicular helper T cells plays an important role in T celsl mediated immune diseases. Interleukin-21 is the main effect factor of Tfh cells;The specific transcription regulation factor is B cell lymphoma 6.Our experiment is trying to detect the expression levels of IL-21 and Bcl-6 in the peripheral blood from eczema patients and healthy controls. Preliminary study on the immune mechanism of IL-21 and Bcl-6 in the pathogenesis of eczema.Our experiment intends to explore the immune mechanism from the following aspects:1. The difference in the expression level of IL-21 m RNA and Bcl-6m RNA in peripheral blood between the patients of eczema and healthy controls.2. The difference in the expression level of IL-21 m RNA and Bcl-6m RNA between the male and female patients.3. The difference in the expression level of IL-21 m RNA and Bcl-6m RNA of different type eczema before treatment.4. The difference in the expression level of IL-21 m RNA and Bcl-6m RNA after the treatment of two weeks and four weeks5.The correlation between the expression level of IL-21 m RNA and Bcl-6m RNA, as well as Eczema Area and Severity Index(EASI) score and laboratory indicators. 6. The correlation between the expression level of IL-21 and Bcl-6, in order to discuss the interaction of the two cytokines in the pathogenesis of eczame.Methods: The 60 cases of eczema patients in experimental group come from the dermatology outpatient of Tianjin union medicine centre during the February of 2014 to January of 2015.In the same period,40 healthy cases from Tianjin Medical University General Hospital was the healthy control group. The experiment uses the real-time fluorescence quantitative reverse transcription polymerase chain reaction(RT-PCR) method to detect the expression of IL-21 m RNA and Bcl-6m RNA in the peripheral blood of 40 cases of healthy persons and 60 cases of eczema patients before treatment, after 2 weeks of treatment and treatment for 4 weeks and then perform statistical analysis. Marks were given to 60 cases according to the EASI score standard.The collection of clinical data and the results obtained use the statistical software SPSS17.0 for statistical processing and analysis, P < 0.05 was significance.Results:1.The expression levels of IL-21 mRNAand Bcl-6mRNA in peripheral blood of patients with eczema was obviously lower than the normal control group( IL-21⊿CT:6.91±1.12 vs 1.59±0.17, P<0.05;Bcl-6⊿CT :9.95±1.57 vs 3.40±0.56, P<0.05).2. The expression levels of IL-21 mRNA and Bcl-6mRNA in peripheral blood of the eczema patients of males and females showed undifferentiated(IL-21⊿CT males vs females:6.99±1.08 vs 6.79±1.17;Bcl-6⊿CT males vs females:10.03±1.55 vs 9.84±1.63;P>0.05).3.There were significant differences in the expression levels of IL-21 m RNAand Bcl-6m RNA in peripheral blood of patienta with different types of eczema;The expression levels of IL-21 m RNAand Bcl-6m RNA in peripheral blood of the acute eczema was lower than the subacute eczema and chronic eczema; The expression levels of IL-21 m RNA and Bcl-6m RNA in peripheral blood of the subacute eczema was lower than the chronic eczema. The expression levels of IL-21 m RNA and Bcl-6m RNA in peripheral blood of the acute eczema, subacute eczema and chronic eczema was(IL-21⊿CT:8.25±0.34 vs 6.71±0.28 vs 5.77±0.59,P<0.05;Bcl-6⊿CT:11.63±0.37 vs 10.19±0.56 vs 8.04±0.59,P<0.05)4. After two-week comprehensive treatment, the expression levels of IL-21 mRNA and Bcl-6m RNA in peripheral blood of the patients increased, and all of them were statistically significant( IL-21 ⊿CT: 5.18±1.37 vs 6.86±1.21, P<0.05; Bcl-6 ⊿CT: 8.10±1.51 vs 9.76±1.66, P<0.05); After four-week comprehensive treatment,the expression levels of IL-21 and Bcl-6m RNA in peripheral blood of the patients were higher than they were after two-week treatment and before treatment, and all of them were statistically significant(IL-21 ⊿CT 2.80±0.55 vs 5.00±1.31 vs 6.73±1.13, P<0.05; Bcl-6 ⊿CT:5.13±1.00 vs 7.93±1.53 vs 9.60±1.60,P<0.05).5. The expression levels between IL-21 m RNA and Bcl-6m RNA in peripheral blood of the eczema patients were negative correlated with the EASI scores and the eosinophils,(P<0.001) meanwhile they both have no correlated with the white blood cells and age.(P>0.05);6. The expression levels between IL-21 m RNA and Bcl-6m RNA in peripheral blood of the eczema patients were positively correlated, and statistically significant(r=0.939, P=0.001).Conclusion:1.The expression levels between IL-21 m RNA and Bcl-6m RNA in peripheral blood of the eczema patients were lower than those of healthy control group and were negative correlated with the EASI score,which indicated that IL-21 and Bcl-6 might play important roles in the pathogenesis of the eczema.2. The expression levels of IL-21 mRNA and Bcl-6m RNA elevated in the patients after tour-week and four-week comprehensive treatment, which proved that we can through adjusting the balance of IL-21 and Bcl-6 cytokines to treatment of the eczema.