Abstract

Objective To explore the expressions of Th17 related cytokines (IL 17,IL23) in peripheral blood and intestinal mucosa of children with Hirschsprung's diseas-associated enterocolitis (HAEC) and examine the role of Th17 related cytokines in the pathogenesis of HAEC.Methods The clinical cases of Hirschsprung's disease were confirmed by pathological findings postoperatively.They were divided into HAEC (n=11) and non HAEC (n=13) groups.In the control group,there were 19 children including inguinal hernia,hydrocele and cryptorchidism.Serum levels of interleukin 17 (IL 17) and interleukin 23 (L23) were measured by enzym-linked immunosorbent assay (ELISA) for different groups.The expressions of IL17 and IL23 in intestinal mucosa were examined by immunohisochemistry.The specimens of spastic and dilated segment in 19 HAEC patients were examined while 4 cases of imperforated anus undergoing colostomy selected as control.Results In HAEC group,the serum level of IL17 (133.23 ± 113.85) pg/ml was significantly higher than that in non HAEC (9.59 ± 7.75) pg/ml and control group (17.96 ± 20.27) pg/ml (P＜0.05).And no statistically significant difference existed between non HAEC and control groups.In HAEC group,the serum level of IL23 (607.29 ± 213.00) pg/ml was significantly higher than that in non HAEC (105.39 ± 90.02) pg/ml and control groups (214.08 ± 227.90) pg/ml (P＜0.05).And no statistically significant difference existed between non HAEC and control groups,Imunohistochemical staining demonstrated that the positive cells of IL-17 and IL-23 in both intestinal epithelial cells and lamina propria of dilated segment was more intensely stained than that in spastic segment and control groups.However,there were no significant inter group differences (F =0.693 & 0.972,P＞0.05).Conclusions In HAEC,Th17 related cytokines (IL17 & IL23) are up regulated in peripheral blood.Thus Th17 related cytokines may be involved in the progression of HAEC.The assays of related cytokines aid an early diagnosis of HAEC.Hopefully a blockade of IL 23/IL 17 signal pathway may become an effective method of preventing and treating HAEC. Key words: Hirschsprung's disease; Enterocolitis; Cytokine

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