Changes Of Peripheral Blood Immune Indicators In Patients With Refractory Chronic Spontaneous Urticaria And Their Relationship With TSLP

Objective:To retrospectively analyze the changes and distribution characteristics of peripheral blood immune indicators in patients with refractory chronic spontaneous urticaria（CSU）and the correlation between the Th1/Th2 immune cell imbalance in peripheral blood and TSLP in patients.Methods:This study includes the following two partsPart Ⅰ:The peripheral blood immune index test data of patients who visited the Department of Dermatology and Venereology from January 1,2017 to December 22,2021 and were diagnosed with refractory CSU were retrieved by keywords in the database of the Information Center of the First Hospital of Lanzhou University,and the patients’medical records and visit records were reviewed by case ID.The information obtained from the retrieval included the patient’s name,age,gender,visit time,hospital visit card number,blood routine,total Ig E,T cell subsets（CD3⁺T,CD3⁺CD4⁺T,CD3⁺CD8⁺T,CD4⁺/CD8⁺T）,regulatory T cells,immunoglobulin Ig A,Ig G,Ig M,and complement C3 and C4 test result indexes,and the results were analyzed by Statistical analysis was performed to observe the abnormal distribution of peripheral blood immunoassay values in patients with refractory CSU.Part Ⅱ:40 patients diagnosed with refractory CSU who visited the Department of Dermatology and Venereology of The First Hospital of Lanzhou University from June1,2021 to February 1,2022 were selected as the case group,and forty healthy patients treated in the Physical Examination Center of The First Hospital of Lanzhou University during the same period were used as the control group.The serum LEVELS of IFN-γ,IL-4 and TSLP were detected by ENZY me-linked immunosorbent assay（ELISA）.SPSS25.0 was used for statistical analysis of the results,To understand the situation of TSLP in refractory CSU patients and its correlation with Th1,Th2 and Ig E.Results:Part Ⅰ:In the retrieval data of 315 patients with refractory CSU,female and adult group accounted for the highest proportion of patients.Among the abnormal changes in peripheral blood immune indexes of patients,abnormal CD4⁺/CD8⁺,serum total Ig E and Treg cell ratios were more common.Among them,the ratio of CD4+/CD8+T cells was more common as the ratio decreased,accounting for 55.77%.The proportion of patients with elevated serum total Ig E was 36.5%.Abnormal elevation was more common in Treg cells,accounting for 15.46%.part:Ⅱ:1)The level of IFN-γin peripheral blood of patients with refractory CSU was significantly lower than that of control group（P<0.01）,and the level of IL-4 was significantly higher than that of control group（P<0.01）.There was no significant difference in TSLP level between the control group and the control group（P=0.386）.Ig E and IL-4 in peripheral blood of patients with refractory CSU were positively correlated with TSLP in peripheral blood.IFN-γwas negatively correlated with TSLP in peripheral blood.Conclusion:1)Abnormal results of immune indicators CD4+/CD8+T,regulatory T cells and total serum Ig E are prone to occur in patients with refractory CSU.Therefore,CSU patients with such abnormal indicators should be more alert to the progression of refractory CSU.2)Compared with healthy controls,the more immune cells in patients with refractory CSU Th1/Th2 disorder,so we should further explore the role of the immune balance in patients with refractory CSU.