Expression of Th17/Treg Cells in Peripheral Blood and Related Cytokines of Patients with Ulcerative Colitis of Different Syndrome Types and Correlation with the Disease.

Jianhu Yu,Shu Wang,Hongsheng Yuan,Miao Bao,Tingyue Qiao

doi:10.1155/2021/4600947

Abstract

Objective To explore the expression of helper T cells 17 (Th17)/regulatory T cells (Treg) in peripheral blood and related cytokines of patients with different types of ulcerative colitis (UC) and analyze their correlation with the disease. Methods From January 2018 to December 2019, 53 patients diagnosed with UC in our hospital were selected. According to their medical syndromes, they were divided into the damp-heat internal accumulation group (n = 35) and the spleen-kidney yang deficiency group (n = 18). 21 healthy volunteers were selected as the control group. The Mayo scoring standard was used to determine the severity of the patient's condition. The expression levels of Th17/Treg cells and related cytokines in peripheral blood were compared between the groups. Pearson correlation was used to analyze the correlation between the ratio of Th17 and Treg cells in the peripheral blood of UC patients and the ratio of TH17/Treg with Mayo score. Results The peripheral blood Th17 cell ratio and Th17/Treg ratio of the damp-heat internal accumulation and spleen-kidney yang deficiency group were higher than those of the control group; the Treg cell ratio was lower than that of the control group; the peripheral blood Th17 cell ratio and Th17/Treg ratio of the damp-heat internal accumulation group were higher those of the spleen-kidney yang deficiency group; and the proportion of Treg cells was lower than that of the spleen-kidney yang deficiency group (P < 0.05). The expression levels of serum IL-6, IL-17, IL-22, and TNF-α in the damp-heat internal accumulation and spleen-kidney yang deficiency group were higher than those of the control group; IL-10 and TGF-β were lower than those of the control group; the levels of serum IL-6, IL-17, IL-22, and TNF-α in the damp-heat internal accumulation group were higher than those of the spleen-kidney yang deficiency group; and both IL-10 and TGF-β were lower than those of the spleen-kidney yang deficiency group (P < 0.05). The peripheral blood Th17 cell ratio and Th17/Treg ratio in the moderately active period group and severely active period group were higher than those of the lightly active period group; the Treg cell ratio was lower than that of the lightly active period group; the peripheral blood Th17 cell ratio and Th17/Treg ratio in the severely active period group were higher than those in the moderately active period group; and the proportion of Treg cells was lower than that of the moderately active period group. Pearson correlation analysis showed that the proportion of Th17 cells and Th17/Treg in peripheral blood of UC patients were both positively correlated with Mayo score (r = 0.762, r = 0.777, P < 0.001). Treg was negatively correlated with Mayo score (r = −0.790, P < 0.001). Conclusion There are differences in the expression of peripheral blood Th17/Treg cells and related cytokines among UC patients with different syndromes, and the damp-heat content is the most significant. The higher the ratio of Th17 cells in peripheral blood and the degree of Th17/Treg imbalance, the lower the ratio of Treg cells, and the more severe the condition of UC patients, which can provide a preliminary quantitative basis for the TCM classification and severity of the diagnosis of UC.

Highlights

Ulcerative colitis (UC) is a chronic nonspecific inflammatory disease that mainly affects the rectum and colonic mucosa [1]
(1) It conformed to the relevant Western medicine diagnosis in the “Consensus on the Diagnosis and Treatment of Inflammatory Bowel Disease (2012 Edition).” is meant (i) persistent or recurrent episodes of diarrhea, mucus pus, and blood in the stool with abdominal pain, Tenesmus, and varying degrees of systemic symptoms; (ii) course of the disease was more than 4 w to 6 w; (iii) there might be extraintestinal manifestations of skin, mucous membranes, joints, and so forth; and (iv) colonoscopy was the most important basis for diagnosing UC; under the microscope, it can be seen that the intestinal mucosa often has superficial erosions and ulcers; there are purulent secretions, mucosal congestion, edema, and blurred blood vessel texture; and the lesions appear continuous and diffuse distribution from the rectum
In Chinese medicine syndrome differentiation, UC is caused by the combined action of original deficiency and superficial reality

Summary

Introduction

Ulcerative colitis (UC) is a chronic nonspecific inflammatory disease that mainly affects the rectum and colonic mucosa [1]. Most patients have abdominal pain, diarrhea, Tenesmus, and other clinical features. Both UC and Crohn’s disease belong to inflammatory bowel disease [2]. Regarding the pathogenesis of UC, clinical considerations are mainly about colonic mucosal epithelial cells secreting abnormal mucus glycoproteins, changes in the permeability of intestinal mucosal, and antigens entering the intestinal mucosa, leading to a series of inflammatory changes and immune responses, and further production of inflammatory mediators and antibodies, cytokines, and oxygen free radicals, but its ultimate pathogenesis and reasons still need to be further studied [4,5,6]. There have been many reports on the role of 17/Treg subgroups in the pathogenesis of UC, and most of them focused on the exploration of western medicine mechanisms. is study explored the differences in

Methods

Results

Conclusion