The Expression And Significance Of Th17 Cell Related Cytokines And CCL20 In The Serum Of Vitiligo Patients

Background:The Th17 associated cytokines have been increasingly implicated in the pathogenesis of cutaneous auto-immune diseases such as psoriasis,How do the Th17 cells migrate to the lesions and play the role of immune damage?Chemokines and their receptors CCL20/CCR6 play important roles in this process.Vitiligo is a common cutanous immune disorder characterized by depigmented patches of skin.However,Whether the Th17 associated cytokines and CCL20/CCR6 play important roles in the etiology of vitiligo have not been well investigated.Objective:To investigate the roles and significance of Th17 cell-associated factors and CCL20 in the pathogenesis of vitiligo by detecting the expression levels of(IL-17,IL-22,IL-23)and CCL20 in the serum of patients with vitiligo,The study might provide new evidence and thought for the mechanism study and treatment of vitiligo.Methods:Study group:46 patients diagnosed as vitiligo in the department of Dermatology,Northern Jiangsu People’s Hospital,including 19 males and 27 females,with an average age of 30.43±19.09 years old from December 2016 to September 2018,All of them have not received systemic therapy,immunosuppressive therapy,topical drug therapy and physical therapy to date or within 3 months,and have excluded other systemic diseases,autoimmune diseases and serious medical system diseases.Control group:41healthy people from Health Check up center in our hospital were enrolled at the same time,including 18 males and 23 females with an average age of 29.83±11.39 years old.They were free of skin diseases or systemic diseases.The gender and age of the twogroups were comparable.Collect patient clinical data,fill out the CRF form,and calculate the VIDA score and collect their serum.The expression level of IL-17,IL-22,IL-23 and CCL20 in the serum were detected by ELISA.Statistical analysis was performed using IBM SPSS23.0 statistical software.If the continuous variables showed a normal distribution,an independent sample t test was used.The mean ± standard deviation is expressed;if the normal distribution is not met,the nonparametric test is used,and the results are expressed as the median(interquartile range),P<0.05 is statistically significant.The continuous variable positive test uses Shapiro-Wilk,P>0.05 to indicate the normal distribution of the variables;the scatter plot to check the outliers.The KDA scores in the Kendall’s tau-b-related evaluation subjects were statistically significant with IL-17,IL-22,IL-23,CCL20,and P<0.01.Correlation analysis of CCL20 with IL-17,IL-22 and IL-23 in Pearson-related evaluation subjects,P<0.01 was statistically significant.Results:The expression level of IL-17 in the study group was(25.36±2.25pg/ml),the level of healthy control group was(12.27±2.30pg/ml),and the expression level of IL-22 in the study group was(21.11±10.49pg/ml).The level of healthy control group was(19.32±13.54pg/ml),the expression level of IL-23 in the study group was(152.48±13.43pg/ml),the level of healthy control group was(141.76±6.56pg/ml),and CCL20 was in study group.The expression level was(710.62±29.27pg/ml),and the level of healthy control group was(570.49±14.48pg/ml).Results Statistical analysis showed that the expression levels of IL-17,IL-23 and CCL20 in the serum of patients with vitiligo were higher than those in healthy controls,and the difference was statistically significant(all P < 0.001);IL-22 in patients with vitiligo was higher than that in healthy controls,but the difference was not statistically significant(P=0.496).Kendall’s tau-b correlation analysis showed that the VIDA score was positively correlated with IL-17,IL-23 and CCL20 levels in patients with vitiligo(Kendall’s tau-b was 0.502,0.505,0.414,respectively);All were statistically significant(P<0.001);There was no correlation between VIDA score and IL-22 level in vitiligo patients(Kendall’s tau-b=-0.057,P=0.615).Pearson correlation analysis showed a positive correlation between IL-17 and CCL20 expression in serum of vitiligo patients(r=0.876,P<0.001);there was no correlation between IL-22 and CCL20 expression(r=-0.229,P=0.126).IL-23 was positively correlated with CCL20 expression(r=0.845,P<0.001).Conclusion:The expressions of IL-17,IL-23 and CCL20 in serum of patients with vitiligo were higher than that of healthy controls group(P<0.001),and there was a positive correlation between VIDA scores(P<0.001),and IL-22 expressions in serum of patients with vitiligo were high,but there was no significant difference compared with the healthy control group(P=0.496),and there was no correlation with the VIDA score(P=0.615)and IL-22 expression level.IL-17 and IL-23 were positively correlated with the expression of CCL20(P<0.001);there was no correlation between IL-22 and CCL20expression(P=0.126).The study showed that IL-17,IL-23 and CCL20 may be involved in the pathogenesis of vitiligo,and may be associated with disease activity.It provided new thoughts for treatment of vitiligo,and whether IL-22 is involved in the pathogenesis of vitiligo needs further investigation.