Study On The Relationship Between TCM Constitutional Types And The Levels Of IL-17 And TGF-?1 In HBeAG Positive Chronic Hepatitis B Patients

Objective:To analyze the relationship between TCM Constitutional Types and Th17 /Treg related cytokines in HBeAg-positive chronic hepatitis B(CHB)patients by detecting the Th17/Treg related cytokines(IL-17 and TGF-?1),and to provide ideas for early TCM intervention.Method:The questionnaire survey of TCM Constitutional Types was conducted with 197 subjects including 167 HBeAg-positive CHB patients and 30 healthy adults.The general data and physicochemical indexes of these subjects were collected.The serum levels of IL-17 and TGF-?1 were detected by ELISA kit.Combined with general data and physical and chemical indicators,we analyzed the relationship between TCM constitutional types and Th17 /Treg related cytokines in patients with HBeAg-positive CHB.Result:1.Among 167 HBeAg-positive CHB patients,144 of them were defined as single constitution,while another 23 of them were defined as mixed constitution.The distribution of the single constitution patients were presented as damp-heat quality > qi-stagnation quality >gentleness quality > yin deficiency quality > sputum dampness quality > qi deficiency quality > yang deficiency quality > stasis blood quality > special quality.Four types within the single constitution patients were classified as common TCM Constitutional Types,including damp-heat quality(44,26.35%),qi-stagnation quality(37,22.16%),gentleness quality(19,11.38%),yin deficiency quality(14,8.98%).2.In the different TCM Constitutional Types of HBeAg-positive CHB patients,the distributions of ALT,AST,HBV DNA level,liver inflammation grade and fibrosis stage showed statistical significance.The levels of ALT and liver inflammation stage in patients with damp-heat quality and yin deficiency quality were higher than those in gentleness quality.3.The serum levels of IL-17/TGF-?1 in HBeAg-positive CHB group was statistical significance,as compared with the control group(P <0.001).4.There was statistical significance of the serum levels of IL-17/TGF-?1 in HBeAg-positive CHB patients with different TCM Constitutional Types: patients in damp-heat quality and yin deficiency had significantly higher levels of IL-17 than that of patients in qi-stagnation quality and gentleness quality.Meanwhile,the highest level of TGF-?1 was found in patients with gentleness quality.5.Serum level of IL-17 in HBeAg-positive CHB patients were positively correlated with ALT level and the liver histological inflammation grade,but no correlation was found between IL-17 level and HBV DNA load;TGF-?1 levels were negatively correlated with ALT levels and liver tissue inflammation grades,and positively correlated with HBV DNA load;neither IL-17 nor TGF-?1 had correlation with liver fibrosis stage.Conclusion:These data indicated that damp-heat quality,qi-stagnation quality,gentleness quality,and yin deficiency quality were classified as the common TCM Constitutional Types of patients in HBeAg-positive CHB,And there were statistical significances in IL-17/TGF-?1 levels inHBeAg-positive CHB patients with different TCM Constitutional Types.Serum levels of IL-17 and TGF-?1 had correlations with ALT levels and liver histological inflammation grade.It is suggested that different TCM Constitutional Types in human body had different immune status.There is a connection between CHB TCM Constitutional Types and cellular immunity,it can improve the immune response status of CHB by adjusting the TCM Constitutional Types in patients with CHB.