Role of minor lymphocyte populations in development of liver fibrosis in children with glycogen storage disease

Abstract

Glycogen storage disease (GSD) is a rare condition that changes the way the body uses and stores glycogen. Objective: to evaluate the content of small populations of lymphocytes and their ratios in children with hepatic forms of glycogen disease depending on the stage of liver fibrosis. 148 children with GSD at the age of Me=7,7 [3,9;11,8] were examined. The comparison group consisted of 54 healthy children. The stage of liver fibrosis was carried out on the FibroScan F502 device (EchoSence, France). Immunophenotyping of lymphocytes was performed on CYTOMICS FC500 (Beckman Coulter, USA). Indicators of lymphocyte populations were analyzed as a percentage of deviation from the age norm. In children with GSD, an increase in the degree of liver fibrosis was revealed from age (R=0.57). Treg content in children with GSD was at the lower limit of the age norm and did not depend on the stage of liver fibrosis. The content of Th17 and Thact lymphocytes was significantly higher than that of the comparison group at all stages of liver fibrosis, starting from stage F1. With an increase in the stage of liver fibrosis, there was an increase in the proportion of patients with Thact and Th17 content exceeding the upper limit of the normative values (PF0-F4=0.021 and PF0-F4=0.012, respectively). An increase in Th17/Treg and Thact/Treg ratios was revealed in patients with GSD relative to the comparison group in all age groups, the dynamics of Th17/Treg and Thact/Treg ratios was characterized by their increase with age. Analysis of indicators depending on the stage of liver fibrosis in children with GSD revealed a significant increase in the Thact/Treg ratio from stage F0 to stages F1, F2, F3 and F4 (PF0-F4=0.000). The Th17/Treg index increased from stage F0 to stages F1, F2, F3 (PF0-F3=0.000).
 An increase in the content of Thact and Th17 lymphocytes, as well as Th17/Treg and Thact/Treg indices with an increase in the stage of liver fibrosis can be used as an additional tool in assessing fibrotic changes in the liver. Immunological indicators objectively reflect the severity of the patient's condition with hepatic forms of GSD.