Clinical Study On Changing Level Of Lymphocyte Subsets Distribution And Cytokines Of Tick-borne Encephalitis

Objective With cytometric beads array and flow cytometry method,the peripheral blood cytokines and lymphocyte subsets level of tick-borne encephalitis and healthy controls are detected respectively in this paper.Comparative analysis is conducted between tick-borne encephalitis and control group,moderate-severe and mild group,as well as acute period and convalescence.The relationship between cytokines and lymphocyte subsets level and tick-borne encephalitis immune imflammatory reaction is studied,which and provides the important immunological indicators for evaluating the illness state and the prognosis.Methods(1)Inpatients in Neurology Department of The Second Clinical Medical School of Inner Mongolia,University for the Nationalities(Inner Mongolia Forestry General Hospital)from May 2015 to September 2016 are collected,and there are a total of 79 patients who are confirmed as tick-borne encephalitis with tick bites.Based on the diagnostic criteria of occupational tick-borne encephalitis GBZ88-2002,according to the different degree of illness state of TBE,there are 28 patients in moderate-severe group and 51 patients in mild group;moreover,according to different courses of disease,there are 47 patients in acute period and 32 patients in convalescence.A total of 20 healthy controls who are examined in the hospital at the same period are collected as the control group.(2)The blood samples with3~5m L of patients who are within 3 days in acute period and who are in convalescence are collected and packed in EDTA anticoagulation purple cap tube and separation gel yellow tube.(3)Peripheral blood cytokines and lymphocyte subsets of tick-borne encephalitis are detected respectively with cytometric beads array and flow cytometry method.(4)Chi-squared test is adopted for enumeration data;mean(standard deviation)shows that measurement data conform to samples of normal distribution,and t test is adopted for comparison among groups;samples of skewed distribution is shown with median(interquartile range),and non-parametric independent sample rank-sum test is adopted for comparison among groups;?=0.05 is inspection level.Results(1)Difference between TBE group and control group1 Cytokines: When TBE group is compared with control group,serum IL-17 A,IFN-?,TNF-?,IL-10,IL-6,IL-4 and IL-2 levels rise significantly,and its difference has statistical significance(p<0.05).2 Lymphocyte subsets: When TBE group is compared with control group,peripheral blood B cell percentage rises significantly,and there is statistical significance(p < 0.05)for the difference;however,there is no statistical significance(p>0.05)for the difference of CD3~+,CD8~+,CD4~+,CD4~+/CD8~+,NK,Treg indicators between two groups.(2)The difference of TBE between moderate-severe group and mild group1 Cytokines: When comparing the moderate-severe group with mild group of TBE,serum IL-6 level rises significantly,with statistical significance(p<0.05)for the difference;while there is no statistical significance(p > 0.05)for the difference of IL-17 A,IFN-?,TNF-?,IL-10,IL-4,IL-2 between two groups.2 Lymphocyte subsets: When comparing moderate-severe group with mild group of TBE,peripheral blood CD3~+ and CD8~+ indicators reduce significantly,B and Treg cells percentage rises significantly,and there is statistical significance(p < 0.05)for the difference;while there is no statistical significance(p>0.05)for the difference of CD4~+,CD4~+/CD8~+,and NK indicators between two groups.(3)The difference between acute period and convalescence of TBE1 Cytokines: Comparing acute period and convalescence of TBE,serum IL-6 level rises significantly,with statistical significance(p < 0.05)for the difference;while there is no statistical significance(p>0.05)for the difference of serum IL-17 A,IFN-?,TNF-?,IL-10,IL-4,and IL-2 levels in two groups.2 Lymphocyte subsets: Comparing acute period and convalescence of TBE,peripheral blood CD3~+and CD8~+indicators reduce significantly,and CD4~+,CD4~+/CD8~+,and B indicators rise significantly(p<0.05);while there is no statistical significance(p>0.05)for the difference of NK and Treg cell percentage in two groups.Conclusion(1)Change of IL-17 A,IFN-?,TNF-?,IL-10,IL-6,IL-4,IL-2 and B cell levels of peripheral blood of tick-borne encephalitis may play an important role in immune pathogenesis of tick-borne encephalitis.(2)Peripheral blood IL-6,CD3~+,CD8~+,B,and Treg indicators change significantly in moderate-severe group of TBE,which can be used as an indicators to judge the severity of the disease.(3)Change of peripheral blood IL-6,CD3~+,CD8~+,D4+,CD4~+/CD8~+,and B indicators,which can be used as an indicators of prognosis.