Expression And Significance Of Cd4~+T Cell Subsets And Cytokines In Patients With Takayasu Arteritis

Objective:To analyze the levels of circulating lymphocyte subsets and serum cytokines in patients with takayasu arteritis(TA)and explore the relationship between their changes and TA disease activity.Methods:A total of 46 TA patients and 43 gender-age-matched healthy controls were enrolled.According to the NIH standard,30 patients were in active disease.Flow cytometry combined with absolute number counting beads was used to detect the absolute numbers and ratios of Th1,Th2,Th17 and Treg cells in peripheral blood of all subjects.Magnetic bead-based multiplex immunoassay was used to detect cytokines and statistical analysis was performed.Clinical data of TA patients were collected,including gender,age,course of disease,clinical symptoms,auxiliary examination,clinical typing,etc.Results:1.In the auxiliary examination,the complement C3,complement C4,CRP,ESR and NIS scores in the disease activity group were higher than those in the inactive group(P<0.001,P<0.001,P=0.012,P=0.019,P<0.001).There were no statistically significant differences in clinical indicators,clinical manifestations,subtypes and composition ratio between the active group and the inactive group of TA patients.2.Correlation analysis results between CD4~+T cell subsets in TA patients and clinical indicators:The absolute numbers of Th2 cells was negatively associated with platelet(PLT),complement C3,C4(C3,C4),and NIS score in TA patients(r=-0.366,P=0.016;r=-0.390,p=0.007;r=-0.435,p=0.002;r=-0.295,p=0.047).The proportion of Th2cells was negatively associated with erythrocyte sedimentation rate(ESR)in TA patients(r=-0.342,P=0.048).The absolute number of Th17 cell was negatively correlated with C3 in TA patients(r=-0.625,P=0.002).3.Results of CD4~+T cell subsets comparison between TA group and healthy control group:the absolute numbers of Th17 cells were markedly increased in TA[(mean±SD:11.4±9.5cells/?L versus 4.6±1.6cells/?L,(P<0.001)].We observed a decline in the absolute numbers of Treg cells,in the peripheral blood of patients with TA as comparedwithhealthygroup[29.7±14.2cells/?Lversus37.1±9.2cells/?L,(P=0.001)].While the Th17/Treg ratio was significantly increased in TA[0.4±0.3%versus 0.1±0.1%,(P<0.001)].4.Results of CD4~+T cell subsets comparison between active and inactive group:we observed an increase in the absolute numbers of Th2 cells in the peripheral blood of patients with active TA compared to those with inactive TA[8.8±5.3 cells/?L versus14.4±6.0cells/?L,(P=0.004)].5.The absolute numbers of Th2 cells was significantly decreased in female patients[9.9±5.9 cells/?L versus 14.6±5.7 cells/?L,(P=0.042)].6.Cytokine expression:the level of IL-6 in patients with disease-active group was significantly higher than that in inactive group(20.2±11.4pg/ml versus 5.8±2.5pg/ml,P=0.002);including IL-17 and TNF-?in active group was greatly higher than that in inactivegroup[(14.3±9.6pg/ml versus 7.5±5.8pg/ml,P=0.027),(8.2±7.6pg/ml versus2.6±2.4 pg/ml,P=0.018)];the concentration of IL-10 in active group was greatly lower than that in inactive group(6.8±4.1pg/ml versus15.4±12.7pg/ml,P=0.035).7.ROC curve results of TA activity prediction:the AUC of Th2 cells,IL-6,IL-10,IL-17,and TNF-?predicted TA activity were 0.763,0.806,0.694,0.704,and 0.76.Conclusion:1.Peripheral Treg cells in TA patients significantly decreased,while Th17 cells increased as compared with healthy controls,leading to an imbalance between Th17 and Treg cells.2.Compared with male TA patients,female TA patients have decreased Th2 cells in peripheral blood.3.the absolute numbers of Th2 cells,IL-6,IL-10,IL-17 and TNF-?are expected to be important markers for the disease activity of TA.