| Henoch-Sch?nlein purpura(HSP)is a common systemic disease with small vasculitis as the main pathological change.Due to the increase of permeability and brittleness of blood vessels induced by inflammation,symmetrical purpura of skin and mucous membrane and bleeding of some organs occurred.More than 90% of the patients are under 10 years old.The main clinical manifestations include symmetrical purpura of the skin,abdominal pain,gastrointestinal bleeding,arthritis and glomerulonephritis,but the platelet count is normal.The course of the disease can be self-limited,but the symptoms are easy to relapse,serious cases can develop into chronic renal failure,It has a very serious impact on the quality of life of patients.For the moment,the exact etiology and pathogenesis of HSP are not completely clear,which may be related to genetic susceptibility,T lymphocyte disorders,abnormal activation of B lymphocytes,etc.Studies have shown that inflammatory mediators and cytokines are involved in the pathogenesis of HSP.Recent studies have found that Th17 cells and related cytokines IL-17 play an important role in infl-ammatory diseases,but the role of Th17 and il-17 in the pathogenesis of HSP has not been fully understood.Interleukin-27(IL-27)is a recently discovered cytokine,produced by antigen presenting cells,which has both anti-inflammatory and pro-inflammatory mechanisms.Study found: IL-27 in infection,tumor,and play an important role in the pathogenesis of autoimmune diseases,but IL-27 in the incidence of allergic purpura role is unclear,this study intends to detect plasma IL-27 patients with HSP,concentration of IL-17 Th17 cells and peripheral blood proportion,and through the exogenous rh IL-27 patients with HSP PBMC cocultivation,again to detect serum Th17 cells in proportion,to explore the relationship between them and HSP,further understanding IL-27,IL-17,the role of Th17 cells in HSP pathogenesis and clinical significance.Objective To investigate the changes of plasma IL-27 and IL-17 in patients with henoch-Sch?nlein purpura,the proportion of Th17 cells in peripheral blood and the correlation,and further clarify the pathogenesis of HSP.Methods A total of 56 patients with acute henoch-Sch?nlein purpura admitted to the first affiliated hospital of An Hui Medical University from December 2017 to July 2019(including 22 patients with simple type,5 patients with abdominal type,6 patients with joint type,19 patients with kidney type and 4 patients with mixed type)were selected as the study group,and 30 volunteers who underwent physical examination during the same period were selected as the control group.Plasma concentrations of IL-27 and IL-17 in the HSP group and the healthy control group were determined by enzyme-linked immunosorbent assay(ELISA).The proportion of Th17 cells in peripheral blood of HSP group and healthy control group was detected by flow cytometry(FCM).Peripheral blood PBMC of the study group and the experimental group was cultured with exogenous rh IL-27,and the proportion of Th17 cells was detected by flow cytometry.Results(1)the plasma concentration of IL-27 in the acute phase of HSP patients was(120.88±9.98)pg/ml,significantly lower than that in the healthy control group(227.13±91.05)pg/ml.And the difference was statistically significant(t=-6.156,P < 0.001).There was no significant difference in IL-27 concentration among different clinical types of HSP patients(F=0.986,P=0.424).(2)The plasma IL-17 concentration in the acute phase of HSP patients was(100.28±17.55)pg/ml,significantly higher than that in the healthy control group(69.29±10.37)pg/ml.And the difference was statistically significant(t=10.142,P < 0.001).There was no significant difference in IL-27 concentration among different clinical types of HSP patients(F=0.759,P=0.557).(3)there was a negative correlation between IL-27 and IL-17 in the plasma of HSP patients in the acute phase(r=-0.320,P=0.016).(4)the proportion of Th17 cells in acute peripheral blood of HSP group in the acute phase was(1.57±0.54)%,significantly higher than that of healthy control group(0.86±0.40)%.And the difference was statistically significant(t=-6.298,p<0.001).(5)Peripheral blood PBMC of the study group was cultured with exogenous rh IL-27,and the proportion of Th17 cells after culture was(0.98±0.44)%,significantly lower than that before culture(1.39±0.52)%,the difference was statistically significant(P < 0.05).Conclusion IL-27 may participate in the pathogenesis of HSP by inhibiting Th17 cell expression of IL-17;IL-27 may be a new target for the treatment of Henoch-Sch?nlein purpura. |
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