Clinical Significance Studies Of Serum IL-23 And IL-17 Levels In Hie Child Patients

Objective Neonatal hypoxic-ischemic encephalopathy(HIE) is closely associated with excessive inflammatory responses. The interleukin-23(IL-23)/ interleukin-17(IL-17) inflammatory axis is one of the most important inflammatory signaling pathways in body, which has a potent proinflammatory role and is known to participate in the occurrence and development of multiple inflammatory diseases, including viral myocarditis and inflammatory bowel disease. However, whether the IL-23/IL-17 inflammatory axis is involved in the pathology remains unclear. The aim of this study was to observe the changes of serum IL-23 and IL-17 levels in children with HIE, and explore their clinical significance.Methods 84 term children with HIE were collected from January 2012 to December 12 2014 in department of neonatology, the First People's Hospital of Huaihua City, which included 38 mild HIE cases, 29 middle HIE cases and 17 severe HIE cases. At the same time, 30 non-infection neonatol jaundice newborns were selected as normal control group at the same period. Peripheral blood(2 ml) was collected before treatment in HIE group, and after postnal 3 days in normal control group. Subsequently, 2 ml of peripheral blood was divided into two parts. On one hand, one part was centrifugated and then was used to detect the levels of IL-23 and IL-17 by using enzyme linked immunosorbent assay(ELISA) in normal control group as well as HIE group. On the other hand, the remaining part was used to measure Th17 cell number in CD4+ cells of peripheral blood through flow cytometry in normal control group and HIE group. Neonatal behavioral neurological assessment(NBNA) was utilized to evaluate neurologic impairment degree before treatment in HIE cases. The correlation between serum levels of IL-23 and IL-17 and NBNA scores were analyzed in HIE cases. The correlation between serum levels of IL-23 and IL-17 and the degree of children with HIE were analyzed in HIE cases.Results1. In comparison with the normal control group, serum IL-23 and IL-17 levels were markedly increased in the HIE group. There was significant difference between HIE group and normal control group(P<0.01).2. The serum levels of IL-23 and IL-17 in mild HIE group, middle HIE group and severe HIE group were higher than those of the normal control group(P<0.05, 0.01). The serum levels of IL-23 and IL-17 were gradually increased with the degree of severity of the HIE groups(P<0.05, 0.01).3. Th17 cell number in CD4+T cells of peripheral blood was significantly increased in HIE group when compared with normal control group(P<0.01).4. In comparison with the normal control group, Th17 cell number in CD4+T cells of peripheral blood was obviously enhanced in mild HIE group, middle HIE group and severe HIE group(P<0.01). Moreover, with the elevation of HIE severity degree, Th17 cell number in CD4+T cells of peripheral blood was gradually increased(P<0.01).5. The serum levels of IL-23 and IL-17 in the group of children with HIE showed significantly positive correlation with NBNA scores(r=0.83,0.81;P<0.05).Conclusion1. A significant increase of serum IL-23 and IL-17 levels as well as Th17 cell number in the peripheral blood emerges in HIE child patients when compared with healthy neonatuses. This suggests that activation of the IL-23/IL-17 inflammatory axis may play an important role in the occurrence and development of HIE.2. Serum levels of IL-23 and IL-17 correlate with clinical grading and NBNA scores in children with HIE. Thus, detection of these cytokine levels may have an important value to judge clinical grading and neurologic impairment degree of HIE child patients.