子宫内膜异位症患者免疫调节Th17细胞及Treg细胞的表达意义

目的探究子宫内膜异位症患者免疫调节Th17细胞及Treg细胞的表达意义。 方法选取2017年1月至2018年12月青岛大学附属医院收治患有子宫内膜异位症的患者,为子宫内膜异位组（EMT组）,选取同一时期在医院因不孕不育进行腹腔镜检查的患者,为正常组（NM组）,两组分别56例。EMT组和NM组患者在一般资料上差异无统计学意义。通过流式细胞仪、HE染色法、qRT-PCR法、ELISA法分析EMT组和NM组患者Th17、Treg细胞所占比例、子宫内膜组织病变情况、ROR-γt、Foxp3 mRNA表达含量的差异性来探究子宫内膜异位症患者Th17细胞及Treg细胞变化。实验结果用 ±s表示,并采用独立样本t检验进行比较。 结果EMT组患者CD4⁺ T细胞中Th17所占比例为5.48±2.81,Treg所占比例为4.22±1.04,NM组Th17所占比例为2.34±1.01,Treg所占比例为6.14±1.52,差异均有统计学意义（t = 7.869,3.015,P = 0.014,0.026）。EMT组患者血清中IL-17水平为（256.38±34.15）?pg/ ml、IL-22为（67.48±10.89）?pg/ml,NM组患者血清中IL-17水平为（198.04±27.59）?pg/ml、IL-22为（43.78±6.92）?pg/ml,差异均有统计学意义（t = 9.944,4.689,P = 0.008,0.017）。EMT组患者血清中IL-10水平为（18.56±4.77）?pg/ml、TGF-β为（148.28±40.52） pg/ ml,NM组患者血清中IL-10水平为（28.35±6.07）pg/ml、TGF-β为（204.78±19.87）pg/ml,差异均有统计学意义（t = 9.491,2.849,P = 0.012,0.034）。EMT组患者子宫内膜组织形态不规则,多数细胞不完整,破损或缺失,且炎性细胞增多,在其周围聚集。NM组患者子宫内膜组织形态规则,细胞没有明显破损或缺失,未见细胞周围炎性因子增多。qRT-PCR检测结果显示,EMT组和NM组ROR-γ mRNA分别为2.89±0.76、1.71±0.26,EMT组和NM组Foxp3 mRNA分别为2.25±0.34、1.13±0.18,两组差异均有统计学意义（t = 10.996,6.759,P = 0.006,0.011）。 结论子宫内膜异位症患者外周血免疫调节细胞Th17/Treg平衡失调,免疫调节紊乱与子宫内膜异位发生、发展有密切关系。     

Frequency and functional activity of Th17, Tc17 and other T-cell subsets in Systemic Lupus Erythematosus

To compare frequency and functional activity of peripheral blood (PB) Th(c)17, Th(c)1 and Treg cells and the amount of type 2 cytokines mRNA we recruited SLE patients in active (n = 15) and inactive disease (n = 19) and healthy age- and gender-matched controls (n = 15). The study of Th(c)17, Th(c)1 and Treg cells was done by flow cytometry and cytokine mRNA by real-time PCR. Compared to NC, SLE patients present an increased proportion of Th(c)17 cells, but with lower amounts of IL-17 per cell and also a decreased frequency of Treg, but with increased production of TGF-β and FoxP3 mRNA. Ιn active compared to inactive SLE, there is a marked decreased in frequency of Th(c)1 cells, an increased production of type 2 cytokines mRNA and a distinct functional profile of Th(c)17 cells. Our findings suggest a functional disequilibrium of T-cell subsets in SLE which may contribute to the inflammatory process and disease pathogenesis.     

Th17细胞和Treg细胞的细胞因子调节网络

Th17细胞和Treg细胞是CD4+T细胞的新亚群,在分化发育、功能发挥的过程中受到Th1型、Th2型效应细胞以及自身分泌产生细胞因子的调节,参与自身免疫病、感染、肿瘤等疾病的发生发展。通过对Th17和Treg分化发育、和功能发挥过程中的关键调节因子进行阻断或加强,可以上调或下调Th17和Treg在疾病中的表达,以用于疾病的预防和诊治。     

Th17细胞和Treg细胞与动脉粥样硬化

动脉粥样硬化从脂质条纹的形成到更复杂的病变和斑块破裂的进程是由多种不同类型的细胞和细胞因子网络共同参与作用的,其中最主要的是Th17细胞和Treg细胞及它们分泌的细胞因子。大量研究显示,Th17细胞对动脉粥样硬化的作用仍存在争议,但大部分研究仍认为其具有促动脉粥样硬化的作用。Treg细胞具有抗动脉粥样硬化的作用,Th17／Treg平衡对动脉粥样硬化的发生和发展具有重要的调节作用。本文将对Th17细胞、Treg细胞的生物学特性以及Th17细胞、Treg细胞和Th17／Treg平衡对动脉粥样硬化影响的最新研究进展做一综述。     

The effects of oxygen–ozone therapy on regulatory T-cell responses in multiple sclerosis patients

Multiple sclerosis (MS) is a common degenerative disorder of the central nervous system. The decreased frequency and dysfunction of Treg cells cause inflammation and disease progression. Ozone autohemotherapy can be used as a potential therapeutic approach to regulate the immune system responses and inflammation in MS. For this purpose, 20 relapsing-remitting multiple sclerosis patients were under treatment with ozone twice weekly for 6 months. The frequency of Treg cell, the expression levels of the Treg cell-related factors (FoxP3, IL-10, TGF-β, miR-17, miR-27, and miR-146A), and the secretion levels of IL-10 and TGF-β were assessed. We found a significant increase in the number of Treg cells, expression levels of FoxP3, miRNAs (miR-17 and miR-27), IL-10, and TGF-β factors in patients after oxygen–ozone (O₂-O₃) therapy compared to before treatment. In contrast, oxygen–ozone therapy notably decreased the expression level of miR-146a in treated patients. Interestingly, the secretion levels of both IL-10 and TGF-β cytokines were considerably increased in both serum and supernatant of cultured peripheral blood mononuclear cells in posttreatment condition compared to pretreatment condition. According to results, oxygen–ozone therapy raised the frequency of Treg cell and its relevant factors in treated MS patients. Oxygen–ozone therapy would contribute to improving the MS patients by elevating the Treg cell responses.     

Role of TGF-β and IL-6 in dendritic cells,Treg and Th17 mediated immune response during experimental cerebral malaria

The role of cytokines in Plasmodium infection have been extensively investigated, but pro and anti inflammatory cytokines mediated imbalance during malaria immune-pathogenesis is still unrevealed. Malaria is associated with the circulating levels of Interleukin-6 (IL-6) and transforming growth factor β (TGF-β), but association between these two cytokines in immune response remains largely obscured. Using mouse model, we proposed that IL-6 and TGF-β are involved in immune regulation of dendritic cells (DC), regulatory T cells (Treg), T-helper cells (Th17) during P. berghei ANKA (PbA) infection. Association between the cytokines and the severity of malaria was established with anti-TGF-β treatment resulting in increased parasitemia and increased immunopathology, whereas; anti-IL-6 treatment delays immunopathology during PbA infection. Further, splenocytes revealed differential alteration of myeloid DC (mDC), plasmocytoid DC (pDC), Treg, Th17 cells following TGF-β and IL-6 neutralization. Interestingly anti-TGF-β reduces CD11c⁺CD8⁺ DC expression, whereas anti-IL-6 administration causes a profound increase during PbA infection in Swiss mice. We observed down regulation of TGF-β, IL-10, NFAT, Foxp3, STAT-5 SMAD-3 and upregulation of IL-6, IL-23, IL-17 and STAT-3 in splenocytes during PbA infection. The STAT activity probably plays differential role in induction of Th17 and Treg cells. Interestingly we found increase in STAT-3 and decrease in STAT-5 expression during PbA infection. This pattern of STAT indicates that possibly TGF-β and IL-6 play a crucial role in differentiation of DCs subsets and Treg/Th17 imbalance during experimental cerebral malaria (ECM).     

Th17/Treg失衡与肝脏免疫病理反应的研究进展

Th17细胞及Th17/Treg失衡在炎症反应、组织损伤及纤维化形成中发挥了重要作用,与多种疾病的发生发展密切相关。前炎性细胞因子可诱导T细胞分化为Th17,使Th17/Treg失衡,导致IL-17、IL-6、趋化因子等促炎性细胞因子大量分泌并有效介导中性粒细胞动员与兴奋,使得机体产生炎症反应与免疫病理反应。就Th17/Treg细胞及其失衡在肝脏免疫病理反应中的研究进展进行了综述。     

Synergistic and additive interactions between receptor signaling networks drive the regulatory T cell versus T helper 17 cell fate choice

CD4+ T cells differentiate into subsets that promote immunity or minimize damage to the host. T helper 17 cells (Th17) are effector cells that function in inflammatory responses. T regulatory cells (Tregs) maintain tolerance and prevent autoimmunity by secreting immunosuppressive cytokines and expressing check point receptors. While the functions of Th17 and Treg cells are different, both cell fate trajectories require T cell receptor (TCR) and TGF-β receptor (TGF-βR) signals, and Th17 polarization requires an additional IL-6 receptor (IL-6R) signal. Utilizing high-resolution phosphoproteomics, we identified that both synergistic and additive interactions between TCR, TGF-βR, and IL-6R shape kinase signaling networks to differentially regulate key pathways during the early phase of Treg versus Th17 induction. Quantitative biochemical analysis revealed that CD4+ T cells integrate receptor signals via SMAD3, which is a mediator of TGF-βR signaling. Treg induction potentiates the formation of the canonical SMAD3/4 trimer to activate a negative feedback loop through kinases PKA and CSK to suppress TCR signaling, phosphatidylinositol metabolism, and mTOR signaling. IL-6R signaling activates STAT3 to bind SMAD3 and block formation of the SMAD3/4 trimer during the early phase of Th17 induction, which leads to elevated TCR and PI3K signaling. These data provide a biochemical mechanism by which CD4+ T cells integrate TCR, TGF-β, and IL-6 signals via generation of alternate SMAD3 complexes that control the development of early signaling networks to potentiate the choice of Treg versus Th17 cell fate.     

TGF-β is necessary for induction of IL-23R and Th17 differentiation by IL-6 and IL-23

TGF-β and IL-6 induce Th17 differentiation, and IL-23 is required for expansion and maintenance of Th17 cells. Recently, it was shown that IL-6 up-regulates IL-23R mRNA in naive CD4⁺ T cells and therefore IL-6 and IL-23 synergistically promote Th17 differentiation. However, the molecular mechanism whereby IL-6 and IL-23 induce Th17 differentiation and the relevance to TGF-β remain unknown. Here, we found that IL-6 up-regulated IL-23R mRNA expression, and IL-6 and IL-23 synergistically augmented its protein expression. The combination induced Th17 differentiation, and TGF-β1 further enhanced it. IL-6 augmented endogenous TGF-β1 mRNA expression, whereas the amount of TGF-β produced was not enough to induce Th17 differentiation by IL-6 alone. However, unexpectedly, the up-regulation of IL-23R and induction of Th17 differentiation by IL-6 and IL-23 were almost completely inhibited by anti-TGF-β. These results suggest that the induction of IL-23R and Th17 differentiation by IL-6 and IL-23 is mediated through endogenously produced TGF-β.     

IL-6单克隆抗体对自身免疫性心肌炎的保护作用及其机制

目的：观察白介素-6（interleukin,IL-6）单克隆抗体（IL-6 mAb）治疗Lewis大鼠自身免疫心肌炎（EAM）的疗效。探讨IL-6与辅助性T细胞17（Th17）、调节性T细胞（Treg）在EAM发病中的机制。方法：将34只8-10周龄Lewis大鼠随机分为正常对照组（n=6）,EAM组（n=12）,IL-6mAb干预组（n=16）。对EAM组和干预组注射心肌肌凝蛋白,干预组于免疫注射后第1、7至第20天腹腔注射IL-6 mAb1nlg,分别于急性峰值期（第21天）、慢性持续期（第84天）取材,观察心肌炎症浸润、纤维化、细胞凋亡以判断IL-6mAb疗效。检测脾脏TH17、Treg细胞数量和功能,比较各组血清中IL-6、IL-10、IL-17和转化生长因子．β（TGF-β）的浓度,实时定量PCR测定外周血STAT3、RORγt、Foxp3mRNA水平,对EAM源性脾细胞进行体外IL-6mAb刺激,并用ELISA法测定IL-10、IL-17和TGF-β的浓度。结果：炎症积分、纤维化积分、凋亡指数IL-6mAb干预组较EAM组明显下降（P〈0．01）。急性峰值期（21d组）EAM组TH17和Treg细胞数量上调,干预组则受明显抑制（P〈0．01）;21d干预组血清IL-6、IL-10、IL-17和TGF-β的浓度较EAM组明显下降（P〈0．01）;21d干预组外周血STAT3、RORγt、Foxp3mRNA水平下降（P〈0．01）;体外IL-6mAb刺激EAM源性脾细胞,IL-10、IL-17和TGF-β表达明显增加。结论：IL6mAb对EAM有明显的保护作用,IL6mAb通过抑制Th17、Treg细胞的数量和功能,实现对EAM的保护作用。     

The effect of pro-inflammatory cytokines on immunophenotype,differentiation capacity and immunomodulatory functions of human mesenchymal stem cells

Mesenchymal stem cells (MSCs), as cells with potential clinical utilities, have demonstrated preferential incorporation into inflammation sites. Immunophenotype and immunomodulatory functions of MSCs could alter by inflamed-microenvironments due to the local pro-inflammatory cytokine milieu. A major cellular mediator with specific function in promoting inflammation and pathogenicity of autoimmunity are IL-17-producing T helper 17 (Th17) cells that polarize in inflamed sites in the presence of pro-inflammatory cytokines such as Interleukin-1β (IL-1β), IL-6 and IL-23. Since MSCs are promising candidate for cell-based therapeutic strategies in inflammatory and autoimmune diseases, Th17 cell polarizing factors may alter MSCs phenotype and function. In this study, human bone-marrow-derived MSCs (BM-MSC) and adipose tissue-derived MSCs (AD-MSC) were cultured with or without IL-1β, IL-6 and IL-23 as pro-inflammatory cytokines. The surface markers and their differentiation capacity were measured in cytokine-untreated and cytokine-treated MSCs. MSCs-mediated immunomodulation was analyzed by their regulatory effects on mixed lymphocyte reaction (MLR) and the level of IL-10, TGF-β, IL-4, IFN-γ and TNF-α production as immunomodulatory cytokines. Pro-inflammatory cytokines showed no effect on MSCs morphology, immunophenotype and co-stimulatory molecules except up-regulation of CD45. Adipogenic and osteogenic differentiation capacity increased in CD45+ MSCs. Moreover, cytokine-treated MSCs preserved the suppressive ability of allogeneic T cell proliferation and produced higher level of TGF-β and lower level of IL-4. We concluded pro-inflammatory cytokines up-regulate the efficacy of MSCs in cell-based therapy of degenerative, inflammatory and autoimmune disorders.     

Nitric oxide modulates TGF-beta-directive signals to suppress Foxp3+ regulatory T cell differentiation and potentiate Th1 development

TGF-β can induce Foxp3(+) inducible regulatory T cells (Treg) and also synergize with IL-6 and IL-4 to induce Th17 and Th9 cells. We now report that NO modulates TGF-β activity away from Treg but toward the Th1 lineage. NO potentiated Th1 differentiation in the presence of TGF-β in both IL-12-independent and -dependent fashions by augmenting IFN-γ-activated STAT-1 and T-bet. Differentiation into Treg, Th1, and Th17 lineages could be modulated by NO competing with other cofactors, such as IL-6 and retinoic acid. NO antagonized IL-6 to block TGF-β-directed Th17 differentiation, and together with IL-6, NO suppressed Treg development induced by TGF-β and retinoic acid. Furthermore, we show that physiologically produced NO from TNF and inducible NO synthase-producing dendritic cells can contribute to Th1 development predominating over Treg development through a synergistic activity induced when these cells cocluster with conventional dendritic cells presenting Ag to naive Th cells. This illustrates that NO is another cofactor allowing TGF-β to participate in development of multiple Th lineages and suggests a new mechanism by which NO, which is associated with protection against intracellular pathogens, might maintain effective Th1 immunity.     

妊娠梅毒患者外周血中Th17和Treg细胞水平及其临床意义分析

目的:探讨妊娠梅毒患者外周血中Th17和Treg细胞水平及其临床意义。方法:选择2015年4月至2016年5月我院收治的35例妊娠梅毒患者作为观察组,并选择同期进行孕检的健康孕妇30例作为对照组。分析和比较其外周血Th17和Treg细胞水平及其诊断妊娠梅毒的临床价值。结果:观察组患者外周血Th17水平显著高于对照组,而外周血Treg水平显著低于对照组(P0.05)。多因素logistic回归分析结果显示外周血Th17和Treg水平与妊娠梅毒发病具有明显相关性。外周血Th17诊断妊娠梅毒的AUC为0.776,95%CI为0.656～0.896,外周血Treg诊断妊娠梅的ROC曲线下的面积(area under curve,AUC)为0.947,95%CI为0.897～997,Th17+Treg诊断妊娠梅毒的AUC为0.960,95%CI为0.913～1.000;Th17和Treg单独检测分别和联合检测曲线下面积比较均具有显著差异(Z=-2.807、-0.375,P0.05);Th17+Treg联合检测的特异度、准确度分别为91.73%、93.28%,显著高于各指标单独检测(P0.05)。结论:妊娠梅毒患者外周血Th17细胞增多,Treg细胞减少,联合检测外周血Th17和Treg细胞水平诊断妊娠梅毒具有较高的准确度,可作为诊断妊娠梅毒的重要参考指标。     

TGF-beta-exposed plasmacytoid dendritic cells participate in Th17 commitment

TGF-β is required for both Foxp3(+) regulatory T cell (Treg) and Th17 commitment. Plasmacytoid DCs (pDC) have been shown to participate to both Treg and Th17 commitment as well. However, few studies have evaluated the direct effect of TGF-β on pDC, and to our knowledge, no study has assessed the capacity of TGF-β-exposed pDC to polarize naive CD4(+) T cells. In this paper, we show that TGF-β-treated pDC favor Th17 but not Treg commitment. This process involves a TGF-β/Smad signal, because TGF-β treatment induced Smad2 phosphorylation in pDC and blockade of TGF-β signaling with the SD208 TGF-βRI kinase inhibitor abrogated Th17 commitment induced by TGF-β-treated pDC. Moreover, TGF-β mRNA synthesis and active TGF-β release were induced in TGF-β-treated pDC and anti-TGF-β Ab blocked Th17 commitment. Unexpectedly, TGF-β treatment also induced increased IL-6 production by pDC, which serves as the other arm for Th17 commitment driven by TGF-β-exposed pDC, because elimination of IL-6-mediated signal with either IL-6- or IL-6Rα-specific Abs prevented Th17 commitment. The in vivo pathogenic role of TGF-β-treated pDC was further confirmed in the Th17-dependent collagen-induced arthritis model in which TGF-β-treated pDC injection significantly increased arthritis severity and pathogenic Th17 cell accumulation in the draining lymph nodes. Thus, our data reveal a previously unrecognized effect of TGF-β-rich environment on pDC ability to trigger Th17 commitment. Such findings have implications in the pathogenesis of autoimmune diseases or immune responses against mucosal extracellular pathogens.     

21例侵袭性肺曲霉病患者Th以及Treg细胞的检测

目的：分析侵袭性肺曲霉病患者辅助性T细胞（Th）以及调节性T细胞（Treg）在外周血中单个核细胞中的表达情况及其临床相关性,探讨Th和Treg细胞介导的免疫反应在侵袭性肺曲霉病中的作用。方法分离21例侵袭性肺曲霉病患者及19例健康人外周血的单个核细胞,采用流式细胞术分析Th1、Th2、Th17、Treg细胞群的表达情况,Real-timePCR方法检测相关转录因子T-bet、GATA-3、RORγt以及Foxp3的表达,ELISA法检测血清中相关细胞因子IFN-γ、IL-4、IL-17以及TGF-β的表达。结果与健康人对照组相比,侵袭性肺曲霉病患者Th1细胞以及Treg细胞占CD4＋T细胞的比例较之对照组明显降低;Th1、Th17、Treg细胞相关转录因子T-bet、RORγt、Foxp3以及相关细胞因子IFN-γ、IL-17A、TGF-β与对照组相比表达明显降低。结论IPA患者的Th1、Th17以及Treg细胞所介导的免疫反应受抑制。     

Murine NKT cells produce Th17 cytokine interleukin-22

Natural killer T (NKT) cells are known to produce Th17 cytokine IL-17 in addition to Th1/2 cytokines. In this study, the ability of NKT cells to produce IL-22, another Th17 cytokine, was examined in mice. When murine spleen cells were stimulated with α-galactosyl ceramide, a ligand for NKT cells, not only Th1/2 cytokines (IFN-γ, IL-4) but Th17 cytokines (IL-17, IL-22) were produced. NKT cells isolated from splenocytes released IL-17 and IL-22 following CD3, CD3/IL-2 or CD3/CD28 stimulation, in which CD3/CD28 costimulation was most effective. Production of IL-17 and IL-22 in CD4+ and CD8+ T cells from splenocytes was little, if any, even after CD3/CD28 costimulation. Treatment with IL-6/TGF-β decreased CD3/CD28-stimulated production of IL-22, but not that of IL-17, in NKT cells. These findings show for the first time that NKT cells are a cell source of IL-22, and that expression of two Th17 cytokines might be regulated in NKT cells by different mechanisms.     

复发性自然流产患者外周血中Th17及Treg细胞及其效应因子的变化

目的:探讨复发性自然流产患者外周血中Th17、Treg细胞以及相关细胞因子的变化。方法:选择复发性自然流产患者25例,正常妊娠妇女25例以及正常非妊娠育龄妇女25例,流式细胞术测定外周血中Th17和Treg细胞数量,ELISA法测定血清IL-10、TGF-β及IL-17的浓度。结果:复发性自然流产患者外周血中Th17细胞百分率显著高于正常妊娠以及正常非孕妇女(P0.05),Treg细胞百分率显著低于正常非孕妇女(P0.05),但与正常妊娠妇女相比无显著性差异(P0.05);复发性自然流产患者外周血IL-10及TGF-β水平显著低于正常妊娠妇女以及正常非孕妇女(P0.05),而IL-17水平显著高于正常妊娠妇女以及正常非孕妇女(P0.05)。结论:外周血Th17细胞数和IL-17水平的升高以及抑制性细胞因子IL-10和TGF-β水平的下降可能是复发性自然流产发生的重要原因。     

良性前列腺增生患者外周血Th17和Treg细胞比率的变化

目的:探讨良性前列腺增生患者外周血Th17和Treg细胞比率的变化。方法:选择33例良性前列腺增生患者及19例正常对照者为研究对象,采用流式细胞术检测和比较其外周血中T淋巴细胞亚群及Th17和Treg细胞占CD4~+T细胞的比率。结果:良性前列腺增生患者外周血Th17和Treg细胞占CD4~+T细胞的比率分别为1.58±0.71和1.76±0.83,Th17/Treg的比率为0.89±0.42。正常健康对照者外周血Th17和Treg细胞占CD4~+T细胞的比率分别为0.75±0.46和1.83±0.75,Th17/Treg的比率为0.41±0.32。良性前列腺增生患者外周血Th17占CD4~+T细胞的比率和Th17/Treg的比率明显高于正常健康对照者(P0.05)。结论:良性前列腺增生患者体内Th17细胞比率升高,Th17/Treg比率失衡,可能与良性前列腺增生的发生、发展有关。