肺炎支原体肺炎患儿外周血单个核细胞TIPE2的表达及与Th17/Treg平衡的相关性

Expression of TIPE2 in peripheral blood mononuclear cells of children with mycoplasma pneumoniae pneumonia and its relationship with Th17/Treg cell balance

摘要:

目的 探讨肺炎支原体肺炎（MPP）患儿外周血单个核细胞TIPE2的表达及与辅助性T细胞17/调节性T细胞（Th17/Treg）平衡的相关性。方法 选取2018年9月—2020年9月济南市第二妇幼保健院收治的MPP急性发作期患儿和恢复期患儿各104例作为研究对象，随机纳入同期该院健康体检儿童90例为对照组。收集血样后分离出单个核细胞，采用酶联免疫吸附试验（ELISA）检测外周血单个核细胞TIPE2；流式细胞术检测Th17、Treg，计算Th17/Treg；ELISA检测白细胞介素-17（IL-17）、白细胞介素-35（IL-35）、C反应蛋白（CRP）、降钙素原（PCT）水平。结果 3组外周血单个核细胞TIPE2、Th17、Treg、Th17/Treg、IL-17、IL-35、CRP、PCT比较，差异有统计学意义（P <0.05）；与对照组比较，恢复组、急性发作组MPP患儿外周血单个核细胞TIPE2、Treg、IL-35水平降低（P <0.05），Th17、Th17/Treg、IL-17、CRP、PCT水平升高（P <0.05）。急性发作组患儿第一秒用力呼气量（FEV₁）、用力肺活量（FVC）、呼气流量峰值（PEF）低于恢复组患儿（P <0.05）。Pearson相关性分析结果显示，MPP患儿外周血单个核细胞TIPE2与Th17、Th17/Treg、IL-17、CRP、PCT呈负相关（P <0.05），与Treg、IL-35及FEV₁、FVC、PEF呈正相关（P <0.05）。多因素Logistic回归分析结果显示，TIPE2［R=2.243（95% CI：1.421，3.541）］、Th17/Treg ［R=1.769（95% CI：1.086，2.882）］和IL-17［R=1.594（95% CI：1.047，2.439）］是影响MPP发生的独立危险因素（P <0.05）。结论 MPP患儿外周血单个核细胞TIPE2水平明显降低，与Th17/Treg平衡呈负相关，可能是影响MPP发生的独立危险因素。

Abstract:

Objective To investigate the expression of tumor necrosis factor-α-induced protein 8-like 2 (TIPE2) in peripheral blood mononuclear cells of children with mycoplasma pneumoniae pneumonia (MPP) and its relationship with T helper 17 (Th17)/regulatory T (Treg) cell balance.Methods A total of 104 children with acute attack of MPP and 104 children at the recovery phase of MPP from September 2018 to September 2020 were selected, and 90 healthy children undergoing physical examination in the same period in our hospital were randomly enrolled as the control group. Mononuclear cells were isolated from blood samples, and the level of TIPE2 protein in peripheral blood mononuclear cells was detected by enzyme-linked immunosorbent assay (ELISA). The frequencies of Th17 and Treg cells were detected by flow cytometry, and Th17/Treg ratio was calculated. Besides, the levels of Th17 cytokine (IL-17), Treg cytokine (IL-35), C-reactive protein (CRP), and procalcitonin (PCT) were detected by ELISA.Results The TIPE2 in peripheral blood mononuclear cells, Th17 frequency, Treg frequency, Th17/Treg ratio, IL-17, IL-35, CRP, and PCT levels were different among the acute attack group, recovery group and the control group (all P < 0.05). Compared with the control group, TIPE2 protein level in peripheral blood mononuclear cells, Treg frequency, and IL-35 level were decreased, but Th17 frequency, Th17/Treg ratio, IL-17, CRP, and PCT levels were increased in the other two groups (P < 0.05). The forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and peak expiratory flow (PEF) in acute attack group were significantly lower than those in recovery group (P < 0.05). Pearson correlation analysis showed that the level of TIPE2 in peripheral blood mononuclear cells negatively correlated with Th17 frequency, Th17/Treg ratio, IL-17, CRP, and PCT (P < 0.05), but positively correlated with Treg frequency, IL-35, FEV₁, FVC, and PEF (P < 0.05). Multivariate Logistic analysis showed that TIPE2 [R = 2.243 (95% CI: 1.421, 3.541)], Th17/Treg ratio [R = 1.769 (95% CI: 1.086, 2.882)] and IL-17 [R=1.594 (95% CI: 1.047, 2.439)] were risk factors for MPP (P < 0.05).Conclusions The expression level of TIPE2 in peripheral blood mononuclear cells of children with MPP is significantly decreased and negatively correlated with Th17/Treg cell balance. TIPE2 in peripheral blood mononuclear cells may be an independent risk factor for MPP.