Correlation Between TCM Syndrome Differentiation And Immunological Status And Expression Of IL-17 And IL-10 In Granulomatous Mastitis

Objective:The correlation between different syndromes of granulomatous mastitis and systemic and local immune status was investigated by detecting the levels of t-cell subsets,immunoglobulin and complement in peripheral blood of patients with different dialectical types of granulomatous mastitis,as well as the expression of t-cell subsets and interleukin-17 and interleukin-10 in local inflammatory tissues.Methods:Collected 67 patients with granulomatous mastitis,according to the type of traditional Chinese medicine is divided into Liver depression and phlegm coagulation syndrome(23 cases),Fever and incandescence syndrome(27cases),Positive deficiency syndrome(17 cases),to detect patients with fasting in the peripheral blood T cell subsets,immunoglobulin and complement levels,including in patients undergoing surgery using immunohistochemistry technique to detect T cell subgroup and IL-17,the expression of IL-10 situation,using SPSS 22.0 software for statistical analysis.Results:1.Among the serum samples of the three groups,the proportionof CD3+ T lymphocytes was within the normal range.The abnormal ratio of CD8+T lymphocyte ratio to CD4+/CD8+ ratio was higher than the normal range,and the proportion of CD4+ T lymphocytes was higher than that.Both the normal range and the lower than normal range were visible,and the Liver depression and phlegm coagulation group and the Fever and incandescence group were mainly increased in the proportion of CD4+ T lymphocytes,and the Positive deficiency group was mainly decreased in the proportion of CD4+ T lymphocytes.The proportion of CD3+ T lymphocytes decreased,and the difference between Liver depression and phlegm coagulation group and Fever and incandescence group was not statistically significant(P>0.05).The proportion of positive deficiency group CD3+ T lymphocytes was significantly lower than that of the other two groups.The difference was statistically significant.Significance(P<0.05).The proportion of CD4+ T lymphocytes increased first and then decreased in the three groups.The difference between Liver depression and phlegm coagulation group and Fever and incandescence group was not statistically significant(P>0.05).The proportion of CD3+ T lymphocytes in patients with positive deficiency group was higher.The other two groups were significantly lower,and the difference was statistically significant(P<0.05).The proportion of CD8+ T lymphocytes increased,and there was no significant difference between the three groups(P>0.05).The ratio of CD4+/CD8+ increased first and then decreased.The difference between Liver depression and phlegm coagulation group and Fever and incandescence group CD4+/CD8+ was not statistically significant(P>0.05),but the ratio of positive deficiency group CD4+/CD8+ was significantly lower than that of the other two groups.The difference was statistically significant(P < 0.05).The abnormalities of serum immunoglobulin in the three groups were higher than the normal range.The Ig G,Ig A and Ig M levels showed an increasing trend.The difference between the Liver depression and phlegm coagulation group and the Fever and incandescence group was not statistically significant(P> 0.05),but comparedwith Positive deficiency group,the difference was statistically significant(P<0.05);Positive deficiency group Ig A,Ig M level was higher than Liver depression and phlegm coagulationgroup,the difference was statistically significant(P<0.05),Ig A,There was no significant statistical difference between Ig M in Liver depression and phlegm coagulation group and Fever and incandescence group and Positive deficiency group and Fever and incandescence group(P>0.05).3.The abnormal results of serological complement in the three groups were higher than the normal range of C3 and lower than the normal range of C4.The levels of complement C3 and C4 increased first and then decreased in the three groups.The difference between Liver depression and phlegm coagulationgroup was not significantly different from that of the other two groups(P>0.05),and the level of positive deficiency group C3 was lower than that of Fever and incandescence group.Statistical significance(P <0.05).There was no significant difference between the levels of Liver depression and phlegm coagulationgroup and Positive deficiency group C4(P>0.05),and the levels of Fever and incandescence group C4 were significantly higher than the other two groups(P<0.05).4.In local tissues,CD4+ T cells and CD8+ T cells were positively expressed.Tissue cytoplasm was stained with brown.CD4 positive particles were widely expressed around the abscess.Lesions were rare in the lesions.CD8 positive particles were more common in lesions.Within the lobule,scattered expression is visible around the abscess.The gray value of CD4(negatively correlated with the positive rate of expression)increased in the three groups,and the difference between Liver depression and phlegm coagulation group and Fever and incandescence group CD4 was not statistically significant(P>0.05).Positive deficiency group and other two groups In comparison,the gray value of CD4 increased,and the difference was statistically significant(P<0.05).The CD8 gray value decreased in the tissues of the three groups.The difference between the Liver depression and phlegm coagulation group and the Fever and incandescence group CD8 was notstatistically significant(P>0.05).Compared with the other two groups,the CD8 gray value decreased.The difference was statistically significant(P <0.05).5.Cytokines IL-17 and IL-10 were positively expressed in the local tissues of the three groups.The positive particles were brown,mainly expressed in the glandular epithelium and interstitial.There was no significant difference in IL-10 gray value between the three groups(P>0.05),IL-17 gray value increased gradually,and there was no significant difference between the Liver depression and phlegm coagulation group and the Fever and incandescence group IL-17 gray value.P>0.05),the gray value of Positive deficiency group IL-17 was higher than the other two groups,and the difference was statistically significant(P<0.05).Conclusions:1.Granulitis and phlegm coagulation syndrome patients with systemic immunity are mainly cellular immunity,humoral immune function is low;Fever and incandescence syndrome patients with cellular immunity is still at a high level,humoral immune function is elevated;Positive deficiency syndrome patients with systemic immunity Mainly humoral immunity,cellular immune function is low.2.Granuloceptive mastitis and phlegm coagulation syndrome patients produce a strong immune response in local tissues and trigger an autoimmune response.Fever and incandescence syndrome maintained a high level of local immune function,and the local immune function of Positive deficiency syndrome was inhibited.Fever and incandescence syndrome may be associated with high expression of CD4.3.The cytokines IL-17 and IL-10 are involved in the development of granulomatous mastitis.The high expression of the immune-promoting factor IL-17 is related to the rapid progression of Liver depression and phlegm coagulation syndrome and Fever and incandescence syndrome;The stable expression of the inhibitory factor IL-10 and the low expression of IL-17 may be related to the prolonged unsuccessful treatment of Positive deficiency syndrome.