The Levels Of Th17, EOS And Relevant Cytokines In The Peripheral Blood Of Patients With Bullous Pemphigoid

Background and purpose:Bullous Pemphigoid (Bullous Pemphigoid, BP) is an autoimmune skin disease, which is more common in clinic? The disease occurs on the elderly patients who have large blisters, severe pruritus, exudation and secondary infection, and all of these injuries seriously impact on quality of their life.In recent years, the studies have found that Th17 cells play an important role in many autoimmune disease.BP is also an autoimmune disease,whethere it is connected with Th17 cells and its cytokines IL-17, there is less study on it at home and abroads.In addition, tissue pathologies in patients with BP show a majority of eosinophils (EOS) infiltration around the blisters and dermal papillas, sometimes there are some neutrophils and lymphocytes. Studies have found that the serum of patients with BP EOS and chemokines-2 (Eotaxin-2) associated with between the severity of the disease. But no research is reported on the relationship between EOS/Eotaxin-2 and the disease activity. This study respectively detects the levels of Th17 cells, IL-17 and EOS, Eotaxin-2 in the BP before and after treatment, and then explore their roles in the pathogenesis of BP, and the relationship between the disease activity.(1) Th17 and IL-17 levels in peripheral blood of bullous pemphigoid patientsMethods:Peripheral bloods were obtained from 27 BP patients (before and after treatment respectively) and 27 normal controls. Enzyme linked immunosorbent assay(ELISA) was performed to detect the level of serum IL-17 and Eotaxin-2. Reverse transcription-polymerase chain reaction(RT-PCR) was applied in the quantitative analysis of the IL-17 and Eotaxin-2 mRNA expression in mononuclear cells in peripheral blood. Flow cytometry (FCM) was carried out to detect the proportion of Th17 cells.Results:1.The expression of IL-17 and IL-17 mRNA in peripheral blood in BP:(1) The level of IL-17 in serum:Elevated expression of IL-17 was noted in pre-treatment serum of BP patients (32.34±9.55 ng/L) compared with post-treatment serum (17.47±3.01 ng/L) and the serum of normal controls (14.74±2.77 ng/L) (both P<0.05).(2) The level of IL-17 mRNA in pre-treatment stage of BP patients was 2.475 times as many as that in post-treatment stage, and was 2.980 times as many as that of normal controls (P<0.05).2.The proportion of peripheral blood Th17 cells in pre-treatment stage in BP patients (3.280%±0.197%) was higher than that in post-treatment stage (0.807%±0.034%) and in normal controls (0.675%±0.019%) (both P<0.05).Conclusion:Th17 and IL-17 may be involved in the pathogenesis of bullous pemphigoid, and play some role in the pathogenesis.(2) Eotaxin-2 levels in peripheral blood of bullous pemphigoid patientsMethods:Peripheral bloods before and after treatments were obtained respectively from a group of 32 BP patients (28 of which are first attack patients while the rest are relapsed) and the other group of 32 normal controls. Enzyme linked immunosorbent assay (ELISA) was performed to investigate the level of serum Eotaxin-2 of the two groups. Reverse transcription-polymerase chain reaction (RT-PCR) was applied in the quantitative analysis of the Eotaxin-2 mRNA expression in mononuclear cells in the peripheral blood samples. Meanwhile,we record data of eosinophils in peripheral blood of BP patients before and after treatment.Results:1.Elevated expression of Eotaxin-2 was noted in pre-treatment serum of BP patients (225.77±36.12 ng/L) compared with post-treatment serum (104.76±18.68 ng/L) and the serum of normal controls (94.55±20.27 ng/L) (both P<0.05).(2) The level of Eotaxin-2 mRNA in pre-treatment stage of BP patients was 4.324 times as many as that in post-treatment stage, and was 4.436 times as many as that of normal controls (P<0.05).2. For the 32 cases, only 6 patients show an EOS level increase before treatments with an average level of (1.58±1.97)×109/L, while 25 cases of the first onset and 4 of the relapse has an evident climbing of Eotaxin-2 expression levels before treatments. All the BP patients'peripheral bloods showed a decreased to normal EOS and Eotaxin-2 levels after the treatments.Conclusion:The Eotacxin-2 is a much more sensitive indicator than EOS in BP.