| Background Psoriasis is a kind of chronic proliferative inflammatory skin diseases with the polygenic inheritance background,the etiology and pathogenetic mechanisms of psoriasis has not been completely clarified,thus leading to the difficulty in the treatment of the disease,and with the characteristics of Longer duration and easy to recurrence,which seriously affect the patient's physical and mental health as well as quality of life at some extent,thus become one of skin diseases that need to pay great attention to prevention and threpay as well as research at home and abroad.Chinese medicine believes that the main pathogenesis of psoriasis is "Blood heat",and blood-heat syndrome is one of its basic syndromes,but blood-heat syndrome essence remains unknown and need to further study.Th 17 cells are a recently discovered novel CD4+T cell subsets that differs from Thl and Th2,which derive from the differentiation of naive CD4+T cells by microenvironments consists of the cytokine TGF-?,IL-?,IL-6,IL-21 and other factors.And produce the main functional effector molecule IL-17A,IL-17F,IL-21 and IL-22.It has been confirmed that Th17 cell paly an important role in the pathogenesis of psoriasis.In addition,It has also been reported NK,NKT,??T and Tc cell play an role in the pathogenesis of psoriasis,but the exact mechanism is unknown.The current level of research,including the activation and proliferation of Th17 cells as well as above mentionted other cells in the peripheral blood of patients with psoriasis and healthy individuals has not been reported.Therefore,it is important to further study the activation and proliferation of Th17 cell as well as other four kinds of cells and Th17 cell related factors level in patients with psoriasis of blood-heat syndrome in vivo,which has important theoretical and practical significance to reveal the immunepathogenesis of psoriasis of blood-heat syndrome and modern medicine material basis of blood-heat syndromeObjective To exzamie Th17,NK,NKT,??T and Tc cell activation associated factor CD38,HLA-DR and proliferation related factors Ki-67 and the serum levels of Thl7 cells differentiation factor TGF-?,IL-?,IL-6 and downstream effector associated factors IL-17A,IL-17F,IL-21,TNF-a,IFN-y in PBMC of patients with blood-heat syndrome of psoriasis,exploring the immunepathogenesis and material foundation of blood-heat syndrome of psoriasis as well as its dialectical basis.Methods The expression of Th17,NK,NKT,??T and Tc cell proliferation related factor Ki-67 and activation related factor CD38,HLA-DR in PBMC of patients with blood-heat syndrome of psoriasis and healthy group was investigated by multicolor flow cytometry;and the serum levels of Th17 cell upstream differentiation factor TGF-?,IL-? and IL-6 and downstream effectors factors IL-17A,IL-17F,IL-21,TNF-a and IFN-y of patients with blood-heat syndrome of psoriasis was examined by immunofluorescence microspheres assay.Results The percentage of Th17 cell express activation-related factors CD38+HLA-DR+was(29.55±14.27)%in psoriatic patients with blood-heat syndrome,and was significantly up-regulated relative to(17.42±9.79)%of the control group.Th17 cells activation levels in patients group is high than that of in healthy controls group;the percentage of Ki-67+was(56.31 ±20.02)%compared with(16.85±9.96)%of the control group,a statistical difference was found in both aspects(P<0.05);And the levels of Th17 cell activation and proliferation were associated with PASI(r=0.693,r=0.482,P<0.05).the percentage of NK cell express CD38+HLA-DR+in patients group was(60.06±14.14)%,and showing a significant increased compared to(48.04±16.68)%of the control group.the percentage of Ki-67+was(48.42±22.10)%in the patient group,which was also significantly increased as compared with(22.31±7.05)%of the control group,the difference showing statistical significance(P<0.05);And there was a relationship between NK cell activation levels and PASI(r=0.518,P<0.05);while proliferation levels was not related to PASI(r=0.023,P>0.05);the percentage of NKT express CD38+HLA-DR+in patients group was(62.90± 17.26)%,while the control group was(55.46± 15.22)%,there was no significant difference(P>0.05),the percentage of expressing Ki-67+was(65.39±23.02)%,A obvious increase was found as compared to(48.61±24.13)%of the control group,the difference was statistically significance(P<0.05).and its proliferation levels was associated with PASI(r=0.413,P<0.05).the percentage of ??T cell express CD38+HLA-DR+in patients group was(50.67± 14.17)%,showing a significant increased as compared with(36.35± 10.70)%of the control group,there was a significant difference(P<0.05);the percentage of expressing Ki-67+was(60.52± 22.35)%,and no significant difference(P>0.05)when compared to(50.08± 17.75)%of the control group.Its activation levels were associated with the PASI score(r=0.531,P<0.05).the percentage of Tc cell express CD38+HLA-DR+in patients group was(45.01 ±21.95)%,and compared with(30.78± 15.32)%in the control group,the difference was not statistically significance(P>0.05).The expression percentage of Ki-67± was(79.37±6.59)%,there was a significantly up-regulated relative to(51.78± 15.87)%of control group,and A significant difference was found(P<0.05).In addition,Tc proliferation level was correlated with PASI score(r=0.682,P<0.05),while there was no correlation between the activation level and PASI score(r=-0.085,P>0.05).The serum levels of Thl7 cell differentiation related factor TGF-?1,IL-6 and IL-1?in patients with mild to severe group were lower than the control group,TGF-?1 of mild group compared with the control group was statistically difference(P<0.05),but there was no significant difference in patients group(P>0.05);the serum levels of IL-6 in patients with mild to moderate group was lower compared to the control group,the difference was statistically significance(P<0.05),while there no significant difference between mild and severe patients group(P>0.05).the serum levels of IL-1? in patients with moderate to severe group and the control group was statistically significance(P<0.05),there was no significant difference in patient group(P>0.05);In terms of Thl7 cell effector cytokines,the serum levels of IL-17A,IL-17F,IL-21 and TNF-a were higher in the patient group compared to control group,and showing a statistically significance(P<0.05),in which IL-17 levels in the severe group was higher than other three groups,the difference was statistically significance(P<0.05),IL-21 levels in severe group was high compared with control group and mild group,and A significant statistically difference was found(P<0.05);the serum levels of IL-17F were not significantly different in patient groups;the serum levels of TNF-a in severe group were also increased than that of the mild group,the difference showing statistically significance(P<0.05);the serum levels of IFN-y in patient groups compared to control group,no significant differences were found(P>0.05),while the serum levels of IFN-y in the severe group were increased as compared to mild group,showing statistically significance(P<0.05).there were no correlation between the serum level of Th17 cell differentiation factor TGF-?,IL-6,IL-1? and PASI scores(r=0.083,r=0.036,r=-0.197,P>0.05);while the serum levels Thl7 cell effector cytokines IL-17A and IL-21 were positively correlated with PASI score(r=0.325,r=0.916,P<0.05);the serum levels of IL-17F,TNF-a and IFN-y were not assotiated with PASI score(r=0.038,r=0.089,r=0.062,P>0.05).Conclusion Th17,NK,NKT,??T and Tc cell activation and proliferation levels were upregulated in the peripheral blood of patients with psoriasis of blood-heat syndrome and Th17 activation and proliferation levels were associated with the disease severity,suggesting that these cells may participate in the pathogenesis process of blood-heat syndrome of of psoriasis,However,Thl7 cells may play a more important role.Th17 cell effector IL-17A,IL-17F,IL-21 and TNF-a serum levels were all up-regulated in PBMC of psoriatic patients,and the serum levels of IL-17 and IL-21 were associated with the severity of the disease,these factors may be be associated with pathogenesis of psoriasis of blood-heat syndrome,nevertheless,IL-17 and IL-21 may be more closely related to the pathogenesis of the disease. |
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