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维生素D对Graves病Th17/Treg细胞失衡的调节作用

Regulating effect of vitamin D on Th17/Treg cell imbalance in patients with Graves' disease

    摘要
  • 摘要:
    目的 探讨维生素D对Graves病（Graves’ disease，GD）患者Th17/Treg失衡的调节作用。
    方法 收集2020年1月至12月复旦大学附属金山医院收治的30例GD患者和30例健康体检者。采用电化学发光免疫法测定2组人群25-羟维生素D水平，将GD患者外周血平均分为2份，根据是否予以维生素D干预分为GD未干预组和GD干预组。比较GD未干预组、GD干预组及对照组外周血中Th17、Treg细胞的占比及Th17/Treg比值。
    结果 GD患者血清25-羟维生素D（20.55±6.69）ng/mL明显低于对照组（25.48±6.12）ng/mL，P=0.004。GD未干预组、GD干预组及对照组外周血的Th17细胞占比分别为（0.299±0.191）%、（0.263±0.176）%、（0.054±0.017）%，两GD组外周血Th17细胞占比均高于对照组（P < 0.001），两GD组外周血Th17细胞水平差异无统计学意义。3组外周血Treg细胞占比分别为（0.029±0.013）%、（0.040±0.019）%、（0.037±0.017）%；两GD组外周血Treg细胞占比与对照组差异无统计学意义，GD干预组外周血Treg细胞占比较GD未干预组升高（P=0.019）。3组研究对象的Th17/Treg细胞比值分别为14.97±8.90、8.08±5.37、1.64±0.67，两GD组外周血Th17/Treg细胞比值明显高于对照组（P < 0.001），GD干预组外周血Th17/Treg细胞比值较GD未干预组外周血下降（P < 0.001）。
    结论 GD患者血清维生素D水平缺乏严重；外周血Th17细胞明显增多，存在Th17/Treg失衡，而25-羟维生素D能上调GD患者Treg细胞，进而调节Th17/Treg细胞失衡。

     

    Abstract:
    Objective To explore the regulating effect of vitamin D on Th17/Treg cell imbalance in patients with Graves' disease.
    Methods Thirty patients with GD and thirty healthy controls in Jinshan Hospital, Fudan University from January to December 2020 were collected.The levels of 25-OH vitamin D in the two groups were measured by electrochemiluminescence immunoassay.The peripheral blood of GD patients was divided into two parts on average as vitamin D non-intervention group and vitamin D intervention group.The percentages of Th17 and Treg cells and Th17/Treg ratio in peripheral blood in GD non-intervention group, GD intervention group and control group were compared.
    Results Serum 25-OH vitamin D (20.55±6.69 ng/mL) in GD patients was significantly lower than that in healthy control group (25.48±6.12 ng/mL, P=0.004).The percentage of Th17 cells in peripheral blood in GD non-intervention group, GD intervention group, and control group were (0.299±0.191)%, (0.263±0.176)%, (0.054±0.017)%, respectively. The percentages of Th17 cells in peripheral blood in two GD groups were significantly higher than that in the control group (P < 0.001). There was no significant difference in the level of Th17 cells in peripheral blood between he two GD groups.The percentage of Treg cells in peripheral blood in the three groups were (0.029±0.013)%, (0.040±0.019)% and (0.037±0.017)%, respectively. There was no significant difference in the percentage of Treg cells in peripheral blood between the two GD groups and the control group. The percentage of Treg cells in GD intervention group was higher than that in GD non-intervention group (P=0.019). The Th17/Treg cell ratio in the three groups were 14.97±8.90, 8.08±5.37, 1.64±0.67, respectively. The ratio of Th17/Treg cells in peripheral blood in the two GD groups was significantly higher than that in the control group (P < 0.001).The ratio of Th17/Treg cells in peripheral blood of GD intervention group was lower than that in the GD non- intervention group (P < 0.001).
    Conclusions For initial GD patients, the serum vitamin D level is seriously deficient, Th17 cell in peripheral blood increases, and Th17/Treg cell is imbalance. Vitamin D plays an important role for up-regulating of Treg cells and regulating Th17/Treg cell imbalance in GD patients.

     

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