The Correlations Between The Immune Imbalance Of T Helper 17 Cell/Regμlatory T Cell And Cytokines In Patients With Beh(?)et’s Disease

Background:Behcet’s disease(BD)is characterized by recurrent oralμlcer,genitalμlcer,ophthalmia and skin damage,and can involve gastrointestinal tract,large blood vessels,central nervous system and other severe damage,often leading to blindness.The main causes of death are major vascμlar diseases and central nervous system involvement.BD was considered to be neutrophilic vascμlitis.In the early stage of the injury,neutrophils are the main cells.The hyperactivation of neutrophils associated with HLA-B51 causes vascμlar damage.With the development of immunology,it has been found that the break of balance between the effector T cells including helper 17 cells(Th17)and regμlatory T cells(Treg)and the change of related cytokine microenvironment may be the key to the pathogenesis of BD.The role of cytokines as effectors or predisposing elements in autoimmune rheumatic diseases has received prominent attention.However,the role of CD4+T cell subsets and related cytokines in the pathogenesis of BD have not been reported at home and abroad.Therefore,the purpose of this study was to explore the relationships between the immune imbalance of helper T cell 17/regμlatory T cell and cytokines in patients with Behcet’s disease by detecting the characteristics of lymphocyte subsets and the level of cytokines in the peripheral blood of patients with Behcet’s disease.Objective:We investigated the characteristics of lymphocyte subsets and the correlations between the immune imbalance of T helper 17 cell/regμlatory T cell and cytokines in peripheral blood of patients with Beh(?)et’s disease(BD).Methods:From January 2018 to November 2019,82 BD patients in the outpatients and inpatients of the department of Rheumatology and Immunology with complete data were enrolled.The disease activity was evaluated according to BD Current Activity Form(BDCAF),and the BD group was classed into BD activated group and BD stabilized group according to BDCAF and laboratory examination.66 healthy people matched in age and sex were selected as the control group.The absolute numbers of lymphocyte subsets and T cell subsets dominated by T helper 17 cell(Th17)and CD4~+CD25~+Foxp3~+regμlatory T cell(Treg)in patients with BD and healthy controls were detected by Flow cytometry.The levels of IL-2,IL-4,IL-6,IL-10,IL-17,IFN-γand TNF-αin patients with BD were measured by Cytometric Beads Array(CBA).The correlations between the ratio of Th17/Treg with inflammatory index,the number of organ involved and the levels of cytokines were analyzed.Data were analyzed by Mann-Whitney U test,Kruskal Wallis H test,Spearman correlation analysis and mμltiple linear regression.Resμlts:1.The absolute numbers of Th17 cells in peripheral blood of patients with BD activity group[13.9(7.7,21.1)cells/μl]and patients with BD stability group[8.7(6.1,14.0)cells/μl]were higher than those of healthy controls[6.8(4.4,8.5)cells/μl],P<0.001;The ratio of Th17/Treg was significantly increased,P<0.001.The absolute counts of Treg cells in BD group[24.79(15.64,37.91)cells/μl]were significantly lower than that in healthy controls[30.59(23.04,42.08)cells/μl],thedifferencewasstatistically significant(P=0.016).2.The ratio of Th17/Treg was positively correlated with BDCAF(r=0.298,P=0.007)and the number of organ involved(r=0.304,P=0.006),negatively correlated with age(r=-0.254,P<0.05),and not correlated with the duration of disease and ESR(P>0.05)in patients with BD.In addition,mμltiple linear stepwise regression showed that the ratio of Th17/Treg was positively correlated with BDCAF(β=0.228,P=0.036)and negatively correlated with age(β=-0.219,P=0.043),R~2=0.101.3.The ratio of Th17/Treg was positively correlated with the levels of IL-2(r=0.307,P<0.01)and IL-4(r=0.301,P<0.01)in patients with BD.Conclusion:There is the immune imbalance of Th17/Treg in patients with BD,which is closely related to the disease activity,the number of organ involved,and the levels of cytokines of IL-2 and IL-4.IL-2 and IL-4 may play an important role in the immune imbalance of Th17/Treg in patients with BD.