Significance Of Expression Changes Of Peripheral Blood Before And After Treatment Of IL-23/Th17 Axis In Patients With Graves Disease

PurposeGraves disease is a common autoimmune thyroid diseases.The pathogenesis of GD is still unclear, the opinion that immune factors plays an important role in the disease process now is universal.Recent studies have found that IL-23/Th17 axis plays an important role in the development of autoimmune disease,but its role in GD disease is still unclear.The article about the IL-23/Th17 axis expression changes in GD patients treatd by methimazol (MMI) and radioactive iodine 131 (131I) has not been reported.In this study we detected dynamicly the level of IL-23/Th17 axis level in GD patients’peripheral blood before and after the treatment with MMI and 131I.And then we preliminarily explore the role of IL-23/Th17 axis in GD pathogenesis and the difference of two treatments affecting the body’s immune function.To provide new targets for comprrhensive treatment.Subjects and MethodsObject of study All GD patients were initial diagnosed by endocrinology in Affiliated Hospital of Jining Medical College from October 2013 to November 2013. MMI therapy group:untreated GD patients 30 case contained 8 male and 22 female, (36.10±9.67) years old, disease duration(5.14±3.20)months,with MMI treatment.131I therapy group:untreated GD patients 31 case contained 9 male and 22 female, (36.42±9.95) years old, disease duration(4.87±5.10)months,with 131I treatment.The subjects were fit into the inclusion and exclusion criterias.Normal control group (NC):gender, age-matched 30 healthy subjects in same period without recent infection, or any family history of autoimmune diseases.Experimental method MMI therapy group patients combined with patient’s age, illness, and the thyroid hormone levels were given regular quantity MMI oral treatment, according to the results of regular review, progression to adjust the dose. All of the 1311 therapy group patients are voluntary choice 131I treatment, by two or more specialist according to 131I dose formula calculation results, and on the basis of individual patients to eventually doses, to a one-time oral treatment. Both of the two groups were divided into before treatment (T0),one month (T1),three months (T3) after MMI or 131I treatment three period. All test subjects were extracted of venous blood 10ml on an empty stomach in the morning.5 mL using flow cytometry test Th17 cells inperipheral blood/CD4+T cells percentage.2mL was evaluated for the levels of thyroid hormone and the thyroid related antibody by the electrochemilximinescence technology. The last 3 mL applying ELISA technology to detect cytokine IL-17, IL-22, IL-23 levels in serum. The data from experiments using SPSS 17.0 forwindows software for statistical analysis, P<0.05 for statistically significant.Results1.Both MMI and 131I therapy group TO patients’serum expressed a significantly highness of Th17 and IL-17,IL-23 than the NC group(P<0.01).But there was no significant difference in the level of IL-22 (P>0.05).2. Analyse the change of the level of Thl7 cells and IL-17,IL-23 in T0, T1,T3 period by one factor repeated measures.The result show a decreases in 131I therapy group,no change in MMI therapy group.3. Compare the levels of IL-17,IL-23 in serum and peripheral Th17 cells in T3 GD patients with NC group,they were still high (P<0.05).4. Between the IL-17, IL-23 and Thl7 cells were positive correlated.All of them with the levels of serum FT3, FT4 showed a positive correlation, but were negatively related to the TSH.Conclusion1.Th17 cells and cytokines of IL-23/Th17 axis in untreated patients with GD were high expressed,so IL-23/Th17 axis may be involved in the pathogenesis of GD.2.Using MMI to treat GD may not effect on the levels of the peripheral IL-23/Th17 axis.3.Radioactive 131I perhaps take an adjuvant therapy on GD dependent on influencing the Th17 cells, IL-17 of the IL-23/Th17 axis.