Plasma Vitamin D,1,25?OH?₂D₃,IL-12 And IL-17 Assays In AR Patients And Their Correlation Studies

BackgroundAllergic rhinitis?AR?is commonly referred to as"hypersensitive rhinitis".It is a variety of immunocompetent cells and cells that are mainly mediated by immunoglobulin E after exposure to allergens.The non-infectious chronic inflammatory disease of the nasal mucosa with epileptic sneezing,salivation and nasal congestion as the main symptoms is a common disease in otolaryngology head and neck surgery.The disease is mostly in children and young adults,and there is no significant difference in gender incidence.The prevalence of the disease is on a global scale.It seriously affects people's quality of life and increases the social burden.Treatment of allergic rhinitis is a problem to be solved in China and the world.Vitamin D is a sterol derivative and was mainly used to treat rickets in the early stage.1,25?OH?₂D₃ is a biologically active form of vitamin D.1,25?OH?₂D₃ has effects on T lymphocytes,B lymphocytes and phagocytic cells,and can directly act on Th1 and Th2 cells to affect the progression of allergic diseases.In recent years,more and more studies have found that AR and vitamins D lacks related.Studies have found that vitamin D can inhibit the excessive differentiation of Th cells into Th2 by promoting the differentiation of Th cells into Th1.Treatment of allergic mice with vitamin D and allergen-specific immunotherapy can increase IL-10 production and potentially inhibit Th2 cytokines.In vitro studies have found that vitamin D has a down-regulation of IL-4 production during initial T cell polarization,inhibiting Th2 cell differentiation,and ultimately slowing the progression of allergic rhinitis.Studies have shown that 1,25?OH?₂D₃ directly inhibits IL-12 production,and1,25?OH?₂D₃ can inhibit the secretion of IL-17 by Th17 cells by directly inhibiting the expression of IL-17.However,the relationship between 1,25?OH?₂D₃ and IL-12and IL-17 is less studied and needs further study.This study investigated the correlation between vitamin D,1,25?OH?₂D₃,IL-12 and IL-17 levels in adult plasma and allergic rhinitis.ObjectiveThe levels of vitamin D,1,25?OH?₂D₃,IL-12 and IL-17 in adult patients with allergic rhinitis were detected by enzyme-linked immunosorbent assay?ELISA?,To investigate the relationship between plasma 1,25?OH?₂D₃,vitamin D,IL-12 and IL-17 and allergic rhinitis in adult patients with allergic rhinitis,and the diagnostic value of vitamin D for allergic rhinitis.Methods70 cases of allergic rhinitis were selected from the outpatient department of our hospital from March 2018 to September 2018.According to the condition,they were divided into mild AR group and medium-severe AR group,of which 27 cases were mild AR group.Medium-severe were 43 cases in the AR group.Forty healthy adults matched for age and sex were selected as the control group.Carefully document the clinical data,relevant medical history,and medication history of all patients.Plasma vitamin D,1,25?OH?₂D₃,IL-12 and IL-17 levels were measured by enzyme-linked immunosorbent assay.1.The concentrations of vitamin D,1,25?OH?₂D₃,IL-12 and IL-17 in peripheral blood of the three groups were compared.2.To compare the correlation of peripheral plasma 1,25?OH?₂D₃ with IL-12 and IL-17 concentrations in the three groups.3.To predict the predictive value of peripheral blood plasma vitamin D and1,25?OH?₂D₃ levels in predicting the severity of allergic rhinitis and allergic rhinitis by ROC curve.The data of this study were processed by SPSS 21.0 statistical software.The measurement data obeying the normal distribution were expressed by the mean±standard deviation.The two groups of independent samples were compared to meet the quantitative data of normal and variance homogeneous distribution.An independent sample t test was used,and the count data was expressed in terms of frequency?%?.Quantitative data correlation analysis that satisfies the normal distribution uses pearson correlation analysis.The receiver's work characteristic curve?ROC curve?was used to analyze the auxiliary diagnostic efficacy of the index;P<0.05 was considered statistically significant.The data of this study were processed by SPSS 21.0 statistical software.The measurement data obeying the normal distribution were expressed by mean±standard deviation.The comparison between the two groups was performed by independent sample t test.The frequency of counting data?%?)said.Correlation analysis was performed using pearson correlation analysis,and the receiver's work characteristic curve?ROC curve?was used to analyze the auxiliary diagnostic efficacy of the index;P<0.05 was considered statistically significant.Results1.Comparison of vitamin D concentration:medium-severe AR group<mild group<control group[?31.61±3.58?ng/ml vs?36.40±3.01?ng/ml vs?42.92±4.07?ng/ml,F=100.128,P<0.001];1,25?OH?₂D₃ concentration comparison:medium-severe AR group<mild group<control group[?22.06±3.72?ng/ml vs?26.93±2.69?ng/ml vs?33.30±4.03?ng/ml,F=99.937,P<0.001],the difference between the groups was statistically significant;2.IL-12 concentration comparison:medium-severe AR group>mild group>control group[?23.49±2.67?pg/ml vs?20.33±2.60?pg/ml vs?13.94±3.16?pg/ml,F=119.439,P<0.001];IL-17 concentration comparison:medium-severe AR group>mild group>control group[?33.01±3.03?pg/ml vs?31.18±2.63?pg/ml vs?23.52±3.79?pg/ml,F=95.832,P<0.001],the difference between the groups was statistically significant;3.Bivariate correlation analysis showed that 1,25?OH?₂D₃ concentration was negatively correlated with plasma IL-17?r=-0.438,P<0.05?in the mild AR group.In the medium-severe AR group,The concentration of 1,25?OH?₂D₃ was negatively correlated with plasma IL-12?r=-0.369,P<0.05?and IL-17?r=-0.560,P<0.001?.4.Through the ROC working curve,the AUC of plasma vitamin D and1,25?OH?₂D₃ for predicting allergic rhinitis were 0.954 and 0.950,respectively?95%CI:0.920-0.987;0.915-0.985;P<0.001?;The sensitivity and specificity of predicting allergic rhinitis were 80.0%and 100.0%when plasma vitamin D was 36.480 ng/ml,and the sensitivity and specificity of allergic rhinitis were predicted when plasma1,25?OH?₂D₃ was 28.005 ng/ml.Degrees are 85.7%and 90.0%,respectively;5.Through the ROC working curve,the AUC of plasma vitamin D and1,25?OH?₂D₃ for predicting allergic rhinitis were 0.854 and 0.866,respectively?95%CI:0.767-0.942;0.782-0.951;P<0.001?;When the plasma vitamin D concentration was 34.060ng/ml,the sensitivity and specificity of predicting allergic rhinitis index were 81.5%and 81.4%,respectively.When the plasma 1,25?OH?₂D₃ concentration was 23.865ng/ml,the index of allergic rhinitis was predicted.Sensitivity and specificity were 92.6%and 76.7%,respectively.Conclusion1.The concentrations of 1,25?OH?₂D₃ and vitamin D in the patients with adult allergic rhinitis were significantly lower than those in healthy people.The levels of IL-12 and IL-17 in the plasma of adults with allergic rhinitis were significantly higher than those in the normal population.Related to the severity of allergic rhinitis;2.Plasma levels of IL-12 and IL-17 are negatively correlated with the concentration of 1,25?OH?₂D₃ in patients with allergic rhinitis.The correlation intensity is related to the severity of allergic rhinitis.This association may be related to the pathogenesis of allergic rhinitis.Related to the mechanism;3.Vitamin D testing provides a new direction for screening allergic rhinitis.