The Research On Peripheral Blood Mononuclear Cells And The Relationship Of Peripheral Blood Mononuclear Cells And The TCM Syndromes SAPHO Patients

Part 1:Detection of Peripheral blood mononuclear cells?PBMC?subsets in SAPHO syndrome[Objective]The SAPHO syndrome?synovitis,acne,pustulosis,hyperostosis,osteitis?is a rare disease and its pathogenesis is not clear.The purpose of this study is to investigate lymphocytes in peripheral blood of SAPHO syndrome patients.[Methods]37 patients with SAPHO syndrome were enrolled as test group,15 healthy volunteers were recruited as healthy controls.The percentages of Th17?IL-17+CD4+T?,Th1?IFN-?+CD4+T?,Th2?IL-4+CD4+T?,Treg?CD4+CD25+Foxp3+T?,Tfh?IL-21+CD4+T?,CD19+B,CD16+CD56+NK and ??T cells were detected by flow cytometry after separation of peripheral blood mononuclear cells from patients and healthy volunteers and changes of balance of Th17/Treg,Th17/Th1,Th1/Th2 were analyzed.Correlations of all cells with BASDAI and VAS reflected disease activitives and ESR and hsCRP reflected inflammation level of disease were analyzed.[Results]There was no difference in gender between SAPHO patients and healthy control patients?P>0.05?Peripheral blood lymphocyte test results:The proportion of Th17 cell in the SAPHO syndrome group was 0.5%,which was significantly higher than the healthy control group?0.2%??p=0.005?;The ratio of Th17/Treg in the SAPHO group was 0.2,and that in the healthy group was 0.1?p=0.009?;The ratio of Thl7/Thl in the SAPHO group was 0.07,which was significantly higher than the healthy control group?0.03??p=0.001?.Comparison of corrations:BASDAI was positively correlated to the proportions of Th17,Th2,Tfh and the ratio of Th17/Treg(r_Th17=0.436,P_Th17=0.007;r_Th2=0.622,P_Th2=0.0001;r_Tfh=0.362,P_Tfh=0.028;r_Thi7/Treg=0.373,P_Th17/Treg=0.023)and negatively correlated with the proportion of ??T(r_??T=-0.38,P??T=0.021);VAS was positively correlated with the proportions of Th17,Th2 and Tfh(r_Th17=0.333,P_Th17=0.044;r_rh2=0.421,P_Th2=0.01;r_Tfh=0.325,P_Tfh=0-049)and negatively correlated with the proportion of ??T and the ratio of Thl/Th2(r_??T=-0.34,P_??T=0.04;r_TH1/Th2=-0.325,P_Th1/Th2=0.049);ESR was positively correlated with the proportion of Th17 and the ratio of Thl7/Treg(r_Th17=0.376,P_Th17=0.022;r_Th17/Treg=0.374,P_Th17/Treg=0.023)and negatively correlated with the proportions of ??T(r_??T=-0.331,P_??T=0.045);hsCRP was positively correlated with the proportion of Thl7?r=0.354,p=0.032?,and negatively correlated with the proportion of Treg?r=-0.375,p=0.03?.[Conclusion]The peripheral blood of Th17,the ratios of Th17/Treg and Thl7/Thl in SAPHO syndrome group are increasing compared with the healthy control group,which suggesting that the pathogenesis of SAPHO syndrome could be related to the increase of Th17 and the ambiance of Th17/Treg and Th17/Thl.Indexes of disease activitives are positively correlated with the proportion of Th17,Th2,Tfh and the ratio of Th17/Treg and negatively correlated with ??T and Th1/Th2.The level of inflammation is positively correlated with the proportion of Th17 and the ratio of Th17/Treg and negatively correlated with ??T and Treg.Part 2:Correlations between Peripheral Blood Lymphocyte Subsets and different types of SAPHO TCM syndromes[Objective]To investigate the expression of lymphocytes in patients with different types of SAPHO Traditional Chinese Medicine?TCM?syndromes and in healthy control group.The correlation was analysed between different types of SAPHO TCM syndromes and patients' individual characteristics,clinical symptom scores,bone and joint involvement sites and laboratory indicators to provide a meaningful and clinical guidance for SAPHO TCM syndromes study.[Methods]We divided 37 SAPHO patients into mainly two TCM Syndrome types:one type is shi-re-bi-zu and the other type is gan-shen-kui-xu.Analysis of individual characteristics?gender,age,duration?,clinical symptom scores?morning stiffness time score,fatigue degree score,pain score?and bone involvement sites?front chest wall,midshaft joint,ankle joint,peripheral joint,limb bone,skull?and laboratory indicators?peripheral blood lymphocytes,blood cell count,?-CTX,BGP,ESR,hsCRP?is whether different or not in our two TCM syndromes.[Results]Individual characteristics:gender,age and duration of disease were not significantly different between shi-re-bi-zu group and gan-shen-kui-xu group?P>0.05?.Clinical symptom scores:the morning stiffness time score of shi-re-bi-zu group?0 point?was significantly less than gan-shen-kui-xu group?2.5 points??P=0.012?;There was no significant difference between the fatigue degree score,BASDAI,VAS in two TCM syndrome groups?P>0.05?.Skeletal involvement:There was no difference of the skeletal involvement between shi-re-bi-zu group and gan-shen-kui-xu group?P=0.927?.Laboratory indicators:the ratio of Thl7/Treg?Th17/Treg=0.13?in shi-re-bi-zu group was lower than that in gan-shen-kui-xu group?Thl7/Treg=0.4??P=0.02?;the red blood cell Counts?RBC=4.65×1012/L?and the basophil counts?BAS=0.03×109/L?in gan-shen-kui-xu group were higher than those in shi-re-bi-zu group?P=0.048 and P=0.034?.?-CTX,BGP,ESR,hsCRP showed no significant differences between the two TCM syndrome groups?P>0.05?.[Conclusion]The score of morning stiffness time,the counts of RBC and BAS and the ratio of Th17/Treg were increased in gan-shen-kui-xu group comparing with shi-re-bi-zu group.Those indexes could help distinguish the two types of TCM syndrome and also provide clinical and laboratory related indicators for gan-shen-kui-xu group.