Th17/Treg Relative Cytokines In Autoimmune Diseases With Pneumonia

Autoimmune diseases(AID) are chronic inflammatory diseases that the body's immune stability are broken, abnormal immune response attack its antigen and damage the body's normal tissues and cells. The routine treatment of patients with AID is the glucocorticoid and immunosuppressive therapy, which suppress the body's immunity and make it easy to merge all kinds of infections, especially the pulmonary infection. And because of the patients' immunity is compromised, the pulmonary infection is not easy to control, it often lead to poor prognosis and high mortality rate. Helper T17(Th17) cells, and regulatory T(Treg) cells and its related factors are research focus in recent years on inflammatory diseases and malignant tumor diseases. Th17 cells mainly secrete interleukin-17A(IL-17A), interleukin-22(IL- 22) and participate in the natural immune response and inflammatory reaction, while Treg cells mainly secrete interleukin-10(IL-10) and participate in negative immune adjustment and immune tolerance. Previous animal and clinical trials showed that Th17/Treg cells related cytokines play an important role in severe pneumonia. The imbalance of Th17/Treg cells and its related cytokines of AID itself makes its role in autoimmune diseases with pneumonia more complicated. Whether Th17/Treg cells related cytokines playan important role in autoimmune diseases with pneumonia, there was no related research. So we took the autoimmune diseases with pneumonia patients as the research object to discuss the role of relative cytokines of the Th17/Treg cells in this disease, and to study the value of these cytokines to predict the severity of this disease and prognosis.Objective To discuss the role of relative cytokines of the helper T 17(Th17) cells and the regulatory T(Treg) cells, interleukin( IL)-17 A, IL-22 and IL-10 in autoimmune disease(AID) with pneumonia, and to study the value of these cytokines to predict the severity of this disease and prognosis.Methods Fifty-two patients diagnosed as AID with pneumonia were allocated to AID with severe pneumonia group(29 individuals) and AID with non-severe pneumonia group(23 individuals) according to Pneumonia Severity Index. And 20 healthy individuals matched with the two groups in sex, age were allocated to the control group. Levels of IL-17 A, IL-22 and IL-10 in serum of 52 patients were determined upon admission and days 5. So did the 20 healthy individuals. And the laboratory examination outcomes, C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), proealcitonin(PCT), white blood cell(WBC) counts and Acute Physiology and Chronic Health Evaluation II(APACHE II) score were collected. And the 52 AID with pneumonia patients were allocated to better-group and worsen-group according to prognosis, then levels of IL-17 A, IL-22 and IL-10 in serum of each group upon admission were compared with days 5 after admission.Results 1.General characteristics of the study population The age, gender, smoking habits, between AID with severe pneumonia group, the AID with non-severepneumonia group and the control group had no significant difference(P>0.05). The autoimmune diseases, comorbidity between AID with severe pneumonia group and the AID with non-severe pneumonia group had no significant difference(P>0.05). 2.IL-17 A, IL-22, and IL-10 The levels of IL-17 A, IL-22, IL-10 of both the AID with severe pneumonia group and the AID with non-severe pneumonia group were higher than the healthy individual group. The levels of IL-17 A, IL-10 of the AID with severe pneumonia group were higher than the AID with non-severe pneumonia group, and there was significant difference(P<0.05). 3.CRP, ESR, PCT, WBC counts The levels of CRP, PCT of the AID with severe pneumonia group were higher than the AID with non-severe pneumonia group, and there was significant difference(P<0.05). 4.The correlation of each index with APACHE II score The levels of IL-17 A, IL-10 in serum showed significant positive correlation with APACHE II score(r=0.639, 0.694, P<0.05).And the levels of IL-22, CRP, ESR, PCT and WBC counts showed no significant correlations with APACHE II score(P>0.05). 5.The change of IL-17 A, IL-22, and IL-10 over time The levels of IL-17 A, IL-22 and IL-10 in serum of the better group declined, whereas the levels of IL-17 A, IL-10 in serum of the worsen group increased, and there were significant difference(P<0.05).Conlusions 1.The relative cytokines of Th17/Treg cells, IL-17 A, IL-22, and IL-10, may play an important role in AID with pneumonia, and detection of their levels in serum dynamically may contribute to predict the prognosis of this disease. 2.The levels of IL-17 A, IL-10 in serum may contribute to predict the the severity of AID with pneumonia, while IL-22 may not.