The Study Of The Expression And Clinical Significance Of Th17 Cell/IL-17

ObjectivesSarcoidosis is a multi-system involving unexplained disease,mainly invading the lungs and lymphatic system.The pathological manifestations are non-caseous necrotizing granulomas.The peak incidence is between 20 and 40 years old,and women are slightly more than men.However,the exact pathogenesis of the disease has not been known so far.In recent years,more and more clinical and basic research suggests that the pathogenesis of sarcoidosis is closely related to T helper cells(Th cells).In this study,we measured the expression of Thl7 cells and their specific cytokines IL-17 by analyzing the expression of Th1,Th2 and Thl7 cell-associated cytokines(IFN-?,IL-4,IL-17 A)in peripheral blood of sarcoidosis patients to investigate the role and potential clinical significance of Thl7 cells and IL-17 in sarcoidosis.MethodsThe study selected 17 sarcoidosis patients diagnosed by clinical,imaging,and pathology from July 2015 to April 2019 in the First Affiliated Hospital of Zhejiang University School of Medicine.We retrospectively summarized their clinical features and laboratory tests,and analyzed Th17 cells/IL-17 by analyzing the levels of Thl,Th2,and Th17-associated cytokines(IFN-y,IL-4,IL-17A)in peripheral blood of patients with sarcoidosis to figure out the relationship with the onset of sarcoidosis.Then we further analyzed the level of IL-17A in patients with sarcoidosis with different disease stages,affected organs,glucocorticoid response,and other blood parameters by comparison of plasma IL-17A levels in patients with sarcoidosis with different disease stages,organ involvement,glucocorticoid response,serum calcium,serum ACE,and other hematological parameters.For the data with normal distribution of measurement data,the mean±standard deviation representation method is adopted,and for the non-normal distribution,the median(interquartile range)representation method is adopted,and the rank sum test is used for comparison.ResultThe proportion of CD3+CD4+T cells in BALF was significantly up-regulated in patients with sarcoidosis,and the abnormal proportion of IL-17A in peripheral blood was significantly higher than that of IFN-y or IL-4.Five patients with abnormal IL-17A expression were stage II sarcoidosis patients and patients with extrathoracic organ/tissue involvement.The statistical method of rank sum test was used to compare the plasma IL-17A levels in patients with sarcoidosis with different disease stages and different degrees of organ involvement.The IL-17A level(0.1,11.16)pg/ml was significantly higher in patients with stage II sarcoidosis than in patients with stage I sarcoidosis(0.1,0.24)pg/ml,and was statistically significant(P=0.018).IL-17A level(0.1,5.51)pg/ml in patients with extrathoracic organ/tissue involvement was higher than IL-17A level in patients with intrathoracic involvement(0.1pg/ml,1.57pg/ml,and was statistically significant(P=0.038)..ConclusionThe abnormal proportion of IL-17A in peripheral blood was significantly higher than that of IFN-y or IL-4,suggesting that Th17/IL-17 may be involved in the pathogenesis of sarcoidosis;Five patients with abnormal IL-17A expression were stage II sarcoidosis patients and patients with extrathoracic organ/tissue involvement.Patients with stage II sarcoidosis had higher levels of IL-17A than patients with stage I sarcoidosis and extrathoracic organs/tissue involvement.The level of IL-17A in patients was higher than that in patients with intrapleural involvement,suggesting that Thl7/IL-17 may be involved in the stage of disease and affected organs of sarcoidosis.