Expression And Clinical Significance Of TH1/TH2,TH17/TREG And YKL-40 In Peripheral Blood Of Patients With Intrahepatic Cholestasis Of Pregnancy

Objectives1.By detecting the expression levels of TH1,TH2,TREG and TH17 in peripheral blood of subjects in each group to explore the relationship between the immune balance of TH1/TH2 and TH17/TREG with the incidence of ICP.2.By detecting the expression level of YKL-40 in serum of subjects in each group to explore whether YKL-40 has clinical significance in ICP patients.MethodsCase-control study was used,68 cases were collected as subjects from the hospital from May 2018 to June 2019.They were divided into normal pregnant women group,mild ICP pregnant women group and severe ICP pregnant women group.There was no statistically difference within the three groups in age,second birth and other aspects.Detecting the expression of TH1,TH2,TREG and TH17 in peripheral blood by flow cytometry and calculating the TH1/TH2 and TH17/TREG in each group.Meanwhile,The expression of level of YKL-40 in peripheral blood was detected by ELISA.Results1.Flow cytometry detection showed that the expression levels of TH1 and TH17 in peripheral blood of ICP group were significantly higher than that in control group and the difference was statistically significant(P<0.05).The expression levels of TH2 and TREG in peripheral blood of ICP group were significantly lower than that in control group and the difference was statistically significant(P<0.05).The expression levels of TH1 and TH17 in peripheral blood of severe ICP group were significantly higher than that in mild ICP group and the difference was statistically significant(P<0.05).The expression levels of TH2 and TREG in peripheral blood of severe ICP group were significantly lower than that in mild ICP group and the difference was statistically significant(P<0.05).2.By calculating the ratios of TH1/TH2 and TH17/TREG,we found that the ratios of TH1/TH2 and TH17/TREG in peripheral blood of the ICP group were significantly higher than those in control group and the difference was statistically significant(P<0.05).The ratios of TH1/TH2 and TH17/TREG in peripheral blood of the severe ICP group were significantly higher than those in mild ICP group and the difference was statistically significant(P<0.05)3.ELISA results showed that the expression level of YKL-40 in serum of ICP patients was significantly higher than that in control group and the difference was statistically significant(P<0.05).The expression level of YKL-40 in serum of severe ICP patients was higher than that in mild ICP patients,but the difference was not statistically significant(P>0.05).4.Through PEARSON correlation analysis,there was a significant correlation between ykl-40 and AST and ALT(P<0.05).There was no correlation between ykl-40 and TBA(P>0.05).Conclusions1.The immune imbalance of TH1/TH2 and TH17/TREG does exist in the peripheral blood of ICP pregnant women,and the ratio of TH1/TH2 and TH17/TREG is positively correlated with the severity of the disease in ICP patients.2.The expression level of YKL-40 in serum of ICP pregnant women was significantly higher than that in the normal control group,and the increase of ykl-40 level may be related to the inflammatory process of ICP.3.YKL-40 is of limited clinical use for diagnosing ICP,but it may be a biomarker of reflecting the treatment of ICP.