Study On The Relationship Between The Imbalance Of T Cell Subsets And IL-33 Levels In Hypertensive Disorder Complicating Pregnancy

Objective To explore the imbalance of Th1/Th2 and Th17/Treg ratio in peripheral blood of patients with gestational hypertension of different severity of blood pressure and the changes of peripheral blood related cytokines,so as to provide theoretical support for the study of gestational hypertension.Methods In this study,90 pregnant women who underwent treatment and obstetric examination in the Maternal and Child Health Hospital of Linyi from September 2017 to August 2018 were selected as the research subjects.According to the diagnostic criteria for gestational hypertension in the eighth edition of "Obstetrics and Gynecology" published by People’s Medical Publishing House,the patients were divided into groups.We selected 60 patients with gestational hypertension as the experimental group.Among them,30 patients with systolic blood pressure ranging from 140 mm Hg to 159 mm Hg and/or diastolic blood pressure ranging from 90 mm Hg to 109 mm Hg were defined as mild gestational hypertension experimental group(LS group).In addition,30 patients with systolic blood pressure ≥ 160 mm Hg and/or diastolic blood pressure ≥ 110 mm Hg were defined as the severe gestational hypertension experimental group(HS group).Meanwhile,30 pregnant women with normal blood pressure during pregnancy were selected as the control group(NC group).There were no differences in age and gestational age among the three groups.The distribution ratios of Th1,Th2,Th17 and Treg in peripheral blood cells of the three groups were detected by flow cytometry.The serum levels of IL-17,IL-33,IFN-γ,IL-4,IL-5,IL-6 and s ST2 in the three groups were detected by Enzyme-linked immunosorbent assay.The expression levels of IL-17 m RNA,Ro Rγt m RNA,IL-33 m RNA and ST2 m RNA in peripheral blood mononuclear cells of the three groups of subjects were detected by Real-time fluorescence quantitative PCR.Results(1)There were no statistically significant differences in age and gestational age among NC group,LS group and HS group(P>0.05).Compared with NC group,the body mass index was higher in LS group and HS group,and the differences were statistically significant(P<0.01).The results of the systolic and diastolic blood pressure of pregnant women among the three groups were compared,and the differences between the groups were statistically significant(P<0.05).(2)Flow cytometry results: Compared with NC group,the distribution ratios of Th1,Th17,Th1/Th2 and Th17/Treg in peripheral blood of LS and HS groups were significantly increased,while the distribution ratios of Th2 and Treg were decreased,and the statistical differences between the groups were statistically significant(P<0.01).At the same time,the distribution ratios of Th1,Th17,Th1/Th2,Th17/Treg in LS group and HS group increased significantly with blood pressure,and the differences were statistically significant(P<0.05).(3)ELISA results: Compared with NC group,the expression levels of IFN-γ,IL-6,IL-17,IL-33 and s ST2 in LS group and HS group were significantly increased,and the differences between groups were statistically significant(P<0.05),the expression levels of IL-4 decreased significantly,and the differences were statistically significant(P<0.01).The expression level of IL-5 in LS group and HS group showed a downward trend,and the difference between HS group and NC group was statistically significant(P<0.01).(4)Real-time quantitative PCR results:Compared with NC group,the m RNA expressions of IL-17 and Ro Rγt in LS group were increased but there were no significant difference(P>0.05),IL-17 m RNA and Ro Rγt m RNA expressions in HS group were significantly increased,and the differences were statistically significant(P<0.05).The m RNA expressions of IL-33 and ST2 in LS group and HS group were significantly increased,and the differences were statistically significant(P<0.01).The m RNA expressions of IL-17,Ro Rγt,IL-33 and ST2 in LS group were significantly different from those in HS group(P<0.05).Conclusion(1)This study suggested that the imbalance of Th1/Th2 and Th17/Treg ratio plays an important role in the mother-fetal immune imbalance.(2)This study suggested that inflammatory cytokines directly or indirectly destroy the permeability of vascular endothelial,and thus further promote the occurrence and development of hypertensive diseases in pregnancy.