| Objective: Through observing the change of the effector T cells,regulatory T cells(Treg),and the mammalian target of rapamycin(mTOR)pathway,we investigate to the effects of ketogenic diet(KD)on immune system and mTOR signaling pathway of the patients with infantile spasms.Methods: Sixty-eight cases of new-onset infantile spasms were divided into 2 groups according to the cases,and ACTH and the KD were administered in each group separately.The percentages of CD4~+CD25~+FOXp3+(Treg)cells,CD4~+INF-?+(Helper T 1,Th1)cells,and CD4~+IL17A+(Helper T 17,Th17)cells were analyzed by flow cytometry.Real-time PCR was performed to evaluate the expression of mTOR,S6 K,and AMP-activated protein kinase(AMPK)in CD4~+CD25~+T cell IL-1,IL-17 A and INF-? in plasma samples were measure by enzyme-linked immunosorbent assay(ELISA).Results: 1.There was no significant difference in the percentage of Treg cell of peripheral blood samples between two groups [(2.15±0.68)% vs(2.30±0.73)%,P>0.05].The proportion of Treg cells in patients of KD group was higher than that in ACTH group[(3.81±0.69)% vs(3.04±0.82)%,P< 0.05];the proportion of Treg cells treated with KD increased significantly(P<0.05),and the proportion of Treg cells after ACTH increased,but with no statistically significant difference(P>0.05).2.There was no significant difference in Th1 and Th17 cells percentage between two groups at baseline [(10.03±2.30)% vs(9.49±2.24)%,P>0.05];[(1.96±0.48)% vs(1.76±0.27)%,P>0.05],and the percentage of Th1 and Th17 cells significantly decreased after KD [(10.03±2.30)% vs(7.63±2.42)%,P< 0.05];[(1.96±0.48)% vs(1.50±0.47)%,P<0.05].The levels of Th1 and Th17 cells in ACTH group were lower than those in KD group[(9.49±2.24)% vs(6.21±1.90)%,P<0.05],[(1.76±0.27)% vs(0.78±0.25)%,P< 0.05].3.The expressions of S6 K at mRNA in CD4~+cell were no significant difference between two groups[(0.177±0.037)vs(0.160±0.021),P>0.05],and were decreased after KD[(0.177±0.037)vs(0.121±0.036),P<0.05].The expression of S6 K mRNA was decreased after ACTH treatment,but there was no significant difference between twogroups[(0.160±0.021)vs(0.144±0.036),P>0.05].4.There was no significant difference in the levels of S6 K at mRNA in CD4~+cell between two groups[(5.51±1.27)×10-2 vs(5.25±1.01)×10-2,P>0.05],and significantly decreased after KD[(5.51±.1.27)×10-2 vs(4.22±0.97)×10-2,P<0.05].Compared to baseline level,the expression of S6 K m RNA after ACTH treatment without significant difference.Conclusion:1.KD can improve the expression level of Treg cells in peripheral blood of children with IS(West Syndrome),and reduce the proportion of Th cell subsets.Thus,it may inhibit the production of inflammatory factors,and relieve immune dysfunction.2.The expression of mTOR and S6 K in CD4~+cells was negatively correlated with Treg cells,and it was positively correlated with Th1 and Th17 cells.It was confirmed that KD could regulate T cell immune dysfunction in children by suppressing m TOR signaling pathway.3.ACTH play an inhibitory effect on effector T cells,but without significant effect on mTOR signaling pathway. |
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