Changes Of Absolute Number Of Treg Cells In Peripheral Blood Of Patients With Autoimmune Uveitis And Evaluation Of Short-term Efficacy And Safety Of Low-dose IL-2 Combined Treatment

Objective:To understand the distribution of peripheral blood T lymphocyte subsets,especially Treg cells,in patients with autoimmune uveitis and the possible mechanisms involved in the development of the disease.To evaluate the short-term efficacy and safety of conventional therapy combined with low-dose IL-2 in the treatment of autoimmune uveitisMethods:We collected 108 patients with autoimmune uveitis and 93 healthy people who were hospitalized in our department from 2016 to 2019,and detected their peripheral blood T lymphocyte subsets by flow cytometry.To analyze the correlation between the levels of CD4 + T cells,CD8 + T cells,Th17 cells,Treg cells and ESR,C-reactive protein.The Treg cells of 33 patients in 108 cases were lower than normal.Among them,23 patients were treated with low dose IL-2(50wiu / day,5 days in a row)on the basis of conventional treatment(methylprednisolone and / or biological preparation).The total T cells,total B cells,CD4 + T cells,NK cells,CD8 + T cells and Th1 cells,Th2 cells,Th17 cells,Treg cells,Th17 / Tr cells in the peripheral blood before and after treatment were detected Eg level.The activity indexes of ESR,C-reactive protein and other diseases in IL-2 treatment group were compared,the recovery of patients’ eyes was observed,and the adverse reactions were recorded.Results:Compared with the normal control group,the total T cells,total B cells,Th cells,TS cells,Th1 cells,Th17 cells,Th1 / Th2,Th17 / Treg cells in patients with autoimmune uveitis were higher than those in the healthy control group(P < 0.05),while the Th2 cells and Treg cells were lower than those in the healthy control group(P < 0.05).CD8 + T cells and Treg cells were negatively correlated with ESR,Th17 / Treg was positively correlated with ESR,Treg cells were negatively correlated with CRP,Th17 / Treg was positively correlated with CRP.After low dose of il-2 combined therapy,the absolute value of NK cells decreased from(299.34±205.91 /ul)to(201.66±156.61 /ul)(P < 0.05),the absolute value of Treg cells increased from(21.90±15.29 /ul)to(51.54±41.86 /ul)(P < 0.05),and the Th17/Treg ratio decreased from 0.44±0.27 to 0.33±0.23(P < 0.05).The effective rate of eye symptom improvement was 95.65%,and no obvious adverse reactions were found.Conclusion:The patients with autoimmune uveitis have the defect of immune tolerance.The abnormal T lymphocyte subsets in peripheral blood,especially Treg cell reduction,may be involved in the pathogenesis of autoimmune uveitis.CD8 + T cells and Treg cells were negatively correlated with ESR,Th17 / Treg was positively correlated with ESR,Treg cells were negatively correlated with CRP,Th17 / Treg was positively correlated with CRP.Low dose IL-2 can specifically stimulate the growth of Treg cells,restore the balance of Th17 / Treg,and help to improve the condition.