Expression And Clinical Significance Of CD83~+DCs、CD1a~+DCs、IL-17 And IL-35 In Serum And Placental Tissues Of Patients With Intrahepatic Cholestasis Of Pregnancy

ObjectivesTo detect the expression of different mature state of dendritic cells(CD83,CDla),IL-17 and IL-35 in serum and placenta tissues in patients with intrahepatic cholestasis of pregnancy(ICP)and normal pregnancy,to analyze their relations and the correlations with the severity of ICP and to explore the immune pathogenesis of ICP,which is helpful to the progress of diagnosis and treatment in clinical work.MethodsCase-control study was adopted.30 cases as control group,and 30 cases of mild ICP group and 25 cases of severe ICP group were selected from Subei people’s Hospital and Yangzhou Women and Children Hospital from January 2015 and July 2016,which were all terminated by cesarean section.There were no statistically differences within the three groups in age,race,gravidity,parity and so on.Other medical and surgical complications were also excluded from the study.The diagnostic standard of ICP was according to "Guidelines for diagnosis and treatment of intrahepatic cholestasis of pregnancy(2015)" published by Obstetrics Subgroup,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Enzyme-linked immunosorbent assay and immunohistochemical SP method were used to detect the expression of CD83,CD1a,IL-17 and IL-35 in serum and placenta,respectively.The results were analyzed by using SPSS 17.0 and P<0.05 indicated statistically.Results(1)There was no significant difference in the expression of CD83+DCs and CD1a+DCs in serum within three groups by enzyme-linked immunosorbent assay(ELISA)(P>0.05).(2)The expression level of IL-17 in serum of patients with ICP was significantly higher than that of control group and the difference was statistically significant(P<0.05).The level of IL-17 in serum of patients with severe ICP was significantly higher than that of mild ICP group(P<0.05).The expression level of IL-35 in serum of patients with ICP was significantly lower than of the control group and the difference was statistically significant(P<0.05).The level of IL-35 in serum of patients with severe ICP was significantly lower than that of mild ICP group and the difference was statistically significant(P<0.05).(3)There was a negative correlation between the expression of IL-17 and IL-35 in serum of normal control group,mild ICP group and severe ICP group(P<0.05).There was no correlation with other factors(P>0.05).(4)CD83+DCs were mainly distributed in the interstitial tissue of the decidua near the glandular epithelium.There was no significant difference in the morphology and distribution of CD83+DCs within the three groups,but the difference was statistically significant in number within the three groups.The expression level of CD83+DCs in placental tissues in ICP was significantly higher than that in the control group and the difference was statistically significant(P<0.05).The expression level of CD83+DCs in placental tissues in mild ICP group was significantly higher than that in the control group(P<0.05);the expression intensity of CD83+DCs in placenta tissues in severe ICP group was significantly higher than that in mild ICP group and the difference was statistically significant(P<0.05).(5)CD1a+DCs were mainly distributed in the interstitial tissue of the decidua,which is close to the glandular epithelium.There was no significant difference in the morphology and distribution of CDla+DCs within the three groups.The expression level of CDla+DCs in placenta tissues with ICP was significantly lower than in the control group and the difference was statistically significant(P<0.05).The expression intensity of CD1a+DCs was lower in placenta tissues with mild ICP than that in the control group(P<0.05).The expression intensity of CDla+DCs was lower in placenta tissues with severe ICP than that in the control group(P<0.05).(6)IL-17 was expressed in trophoblast and decidua in placenta tissues,and there was significant difference within the three groups(P<0.05).The expression level of II-17 in ICP was significantly higher than that in the control group,and the expression level in severe ICP group was higher than that in the mild ICP group.The expression level of IL-17 in mild ICP group in placental tissues was higher than that in the control group(P<0.05).(7)The expression of IL-35 in placenta trophoblast and decidua were significantly different within the three groups.The expression level in ICP group was significantly lower than that in the control group and the expression level in placenta tissues in severe ICP group was lower than that in the mild ICP group.The expression level in the mild ICP group in placenta tissues was lower than that in the control group(P<0.05).(8)There was a negative correlation between the levels of CD83+DCs and CD1a+DCs,IL-35 in the placenta tissues in normal control group,mild ICP group and severe ICP group.The expression of CD83+DCs was positively correlated with IL-17.There is a negative correlation between the expression of CD1a+DCs and IL-17.The expression of CD1a+DCs was positively related to the expression of IL-35.The expression of IL-17 was negatively correlated with IL-35(P<0.05).(9)The expression of CD83+DCs and CDla+DCs in serum and placenta has no correlation(P>0.05).The expression of IL-17 in serum and placenta was positively correlated(P<0.05).The expression of IL-35 in serum and placenta was positively correlated(P<0.05).Conclusions(1)The expression of CD83+DCs increased in patients with ICP,and the expression of CD1a+DCs decreased in patients with ICP.(2)The expression of IL-17 was enhanced in patients with ICP,and the expression of IL-35 was attenuated in patients with ICP.(3)There was certain correlation within the four factors in patients with ICP,which indicated that the inflammatory factor was involved in the occurrence of ICP.