The Expression And Significance Of Treg And Th17 In Peripheral Blood Of Pediatric Liver Transplantation Patients With Biliary Atresia

Objective:To study the expression of CD4+CD25+Foxp3+ regulatory T cells(Treg)and T helper cell 17(Th17)in peripheral blood of peditric liver transplantation patients with biliary atresia and analyse their clinical significance.Methods: 42 children who receieved postoperative check or initial liver transplantation(LT)in the department of pediatric liver transplant surgery of Tianjin First Central Hospital from June 2016 to April 2017 were included in this study,the primiary disease was biliary atresia(BA).Among them,12 cases who received LT were included in the operation observation group and they were taken peripheral blood samples before LT,two weeks and one month after LT.19 cases who had received LT more than one year and had stable clinical status were selected as long-term surviving group.Acording to the concentration of Tacrolimus(FK506),the stable group were divided into low concentration group(FK506<4.0ng/ml)and high concentration group(FK506?4.0ng/ml).11 cases who had acute rejection after LT were included in the rejection group and were taken peripheral blood samples before and after antirejection therapy respectively.while 10 healthy children were included in the health control group.Stained all blood samples with flurescent antibodies and detected the expression of Treg,Th17 and cytotoxic T cell(CTL)by flow cytometry.The differences of Treg and Th17 were comparerd among groups respectively and their significance was analyzed.Results: The percentages of Treg of different time in the operation observation group were lower than that of the health control group(P<0.05).The percentage of Treg pre-LT was higher than that of two-weeks post-LT(P=0.000)and one-month post-LT(P=0.000),but the percentages of Treg between two-weeks post-LT and one-month post-LT showed no significant difference(P=0.475).The percentages of Th17 of different time post-LT were higer than that of the health control group(P<0.05).The percentages of Th17 of pre-LT and post-LT showed no significant difference(P=0.119).The percentage of Treg of the long-term surviving group was lower than that of the health control group(P=0.021),while the percentages of Treg between one-year post-LT and two-year post-LT showed no significant differ-ence(P=0.077).The percentage of Th17 of the long-term surviving group was higher than that of the health control group(P=0.008),while the percentage of Th17 of two-year post-LT was lower than that of one-year post-LT(P=0.028).For the FK506,the percentages of Treg of both high concentration group and low concentration group were lower than that of the health control group(P<0.05),while the percentages of Treg between high concentration group and low concentration group showed no significant difference(P=0.876).There was no linear correlation between the FK506 concentration and Treg percentage(P=0.611).The percentages of Th17 of both high concentration group and low concentration group were higher than that of the health control group(P<0.05),while the percentages of Th17 between high concentration group and low concentration group showed no significant difference(P=0.396).There was no linear correlation between the FK506 concentration and Th17 percentage(P=0.729).For the the rejection group,the percentage of Treg of pre-antirejection was lower than that of the long-term surviving group(P=0.000)and the health control group(P=0.000),while the percentage of Treg of post-antirejection was lower than that of pre-antirejection(P=0.001).The percentage of Th17 of pre-antirejection was higher than that of the long-term surviving group(P=0.000)and the health control group(P=0.000),while the percentage of Th17 of post-antirejection was lower than that of pre-antirejection(P=0.000).The percentage of CTL of the long-term surviving group was higher than that of the health control group(P=0.015).The percentage of CTL of pre-antirejection was higher than that of the long-term surviving group(P=0.000)and the health control group(P=0.000),while the percentage of CTL of post-antirejection was lower than that of pre-antirejection(P=0.001).Conclusions:(1)The percentages of Treg of the patients with BA during the early post-operative period(one month post-LT)were lower than that of healthy children,it displayed a decreasing trend during the early post-operative period.The percentages of Th17 of the patients post-LT were higher than that of healthy children,it showed no much change during the early post-operative period.FK506 had powerfully inhibitory effect on the percentage of Treg and less suppression on the percentage of Th17.FK506 concentration had no correlation with the percentage of both Treg and Th17.when rejection happened after LT,the percentage of Treg in peripheral blood of the patients with BA declined,while the percentage of Th17 rose.