Analysis Of Immunological Characteristics And Risk Factors In Newly Diagnosed Primary Sj?gren's Syndrome Patients With Positive TPOAb

Objective:To study the immunological characteristics of primary Sj?gren's syndrome patients with positive TPOAb,analyze the risk factors affecting TPOAb level,in order to clarify the immunological pathogenesis of elevated TPOAb level,and lay a foundation for the prevention and treatment of elevated TPOAb level and its adverse consequences.Methods:Retrospective analysis was performed on 70 newly diagnosed female patients with p SS who were hospitalized in the department of rheumatology,the second hospital of shanxi medical university from May 2018 to December 2019.PSS diagnosis is based on the 2002 international classification of p SS.According to TPOAb level,TPOAb positive group(TPOAb > 9IU/ml)and TPOAb negative group(TPOAb?9IU/ml)were divided into two groups.Differences in age,disease course,general biochemical and immunological indicators were compared between the two groups,and risk factors affecting blood TPOAb level were determined by univariate and multivariate Logistic regression analysis.Results:Of the 70 female patients with initial p SS,21 were positive for TPOAb,with a positive TPOAb rate of 30%.The absolute value of peripheral blood lymphocytes,natural killer(NK)cells,NK cells/regulatory T cells(Treg)ratio,immunoglobulin G(Ig G)and anti-thyroglobulin antibody(TGAb)in the tpoab-positive group were significantly higher than those in the tpoab-negative group(P < 0.05).Interleukin-2(IL-2)?Interleukin-4(IL-4)?Interleukin-10(IL-10)?Interleukin-17(IL-17)and Interferon-?(IFN-?)were significantly lower in the tpoab-positive group than in the tpoab-negative group(P < 0.05).Univariate logistic regression analysis showed that the absolute value of lymphocytes(OR=4.29,95% CI: 1.44-13.33,P=0.0096),immunoglobulin G(OR=8.00,95% CI: 2.33-37.42,P=0.0025),NK cells(OR=6.60,95% CI: 1.93-25.18,P=0.0035),and NKcell/Treg(OR=4.89,95% CI:1.62-15.54,P=0.0055)were risk factors for elevated TPOAb level.IL-10(OR=0.14,95% CI: 0.02-0.56,P=0.0138),IL-17(OR=0.15,95% CI: 0.01-0.87,P=0.0826),and IFN?(OR=0.11,95% CI: 0.01-0.63,P=0.0420)were protective factors for elevated TPOAb levels.Multivariate Logistic regression analysis showed that the absolute value of lymphocytes(OR=5.81,95% CI: 1.43-28.27,P=0.0186),Ig G(OR=11.64,95% CI: 2.75-68.53,P=0.0022)and NK cells /Treg(OR=5.34,95% CI: 1.28-26.39,P=0.0267)are independent risk factors for elevated TPOAb level,while IL-10(OR=0.14,95% CI: 0.02-0.76,P=0.0390)is an independent protective factor of elevated TPOAb level.Conclusion:The positive rate of TPOAb was as high as 30% in female patients with primary PSS.NK cell / Treg ratio and low IL-10 were independent risk factors for the increase of TPOAb level in patients with primary PSS.Further study on the causal relationship between NK cell / Treg ratio,IL-10 level and TPOAb level is of great significance for the prevention and treatment of Hashimoto's thyroiditis and related diseases.