宫颈癌组织中Th1/Th2类细胞因子的漂移研究

目的:观察宫颈癌组织中Th1/Th2类细胞因子的漂移情况。方法:选以IL-2和IFN-γ代表Th1类细胞因子,IL-4和IL-6代表Th2类细胞因子,通过逆转录聚合酶链反应(RT-PCR)检测25例宫颈癌癌组织中Th1/Th2类细胞因子mRNA的表达。结果:IIIB期宫颈癌组织中,Th1型细胞因子的表达显著低于IB期、IIA期、IIB期,Th2型细胞因子的表达显著高于IB期、IIA期、IIB期,差异均有统计学意义(P0.05)。Ⅰ期和Ⅱ期宫颈癌以Th1型细胞因子表达为主。25例宫颈癌组织中,13例呈典型的Th1类细胞因子的强势表达,7例为Th2型,5例为Th0型,随着宫颈癌分期的增高,由Th1向Th2漂移(P0.05)。结论:IB期、IIA期、IIB期宫颈癌患者组织中细胞因子呈Th1状态,IIIA期呈Th0状态,IIIB期呈Th2状态,随着宫颈癌分期的增高,由Th1向Th2漂移。     

慢性乙肝病毒感染患者肝纤维化、肝功能及Th1/Th2细胞因子水平变化及恩替卡韦干预研究

摘要 目的：研究慢性乙肝病毒（HBV）感染患者肝纤维化、肝功能及Th1/Th2细胞因子水平的变化情况,并分析恩替卡韦干预对慢性HBV感染患者相关指标的影响。方法：选择2016年4月至2018年1月我院收治的120例慢性HBV感染者为研究对象,其中慢性乙肝轻度50例、中度24例、重度21例、肝硬化者25例,并选择同期于我院进行体检的50例健康者为健康对照组,分析不同病情慢性HBV感染患者血清中的肝纤维化指标[透明质酸（HA）、Ⅳ型胶原（ⅣC）,层粘连蛋白（LN）、III型前胶原肽（PC III）]、肝功能指标[丙氨酸转氨酶（ALT）、天冬氨酸转移酶（AST）]及Th1/Th2细胞因子[干扰素-γ（IFN-γ）、白介素-2（IL-2）、白介素-4（IL-4）、白介素-6（IL-6）]的变化,慢性HBV感染患者按照随机数字表法分为观察组和对照组,对照组给予还原型谷胱甘肽和复方甘草酸苷等常规护肝治疗,观察组在对照组基础上另口服恩替卡韦分散片治疗,对比两组治疗前后各指标水平。结果：慢性HBV感染患者的肝纤维化指标、肝功能指标及Th1/Th2细胞因子IL-4、IL-6等指标水平均显著高于健康对照组,且随着病情的加重呈逐渐上升趋势;而IFN-γ和IL-2水平均低于健康对照组,随着病情的加重而逐渐降低（P<0.05）。治疗后两组血清肝纤维化指标（HA、ⅣC、LN、PC III）、肝功能指标（ALT、AST）以及IL-4、IL-6水平均显著低于治疗前,且观察组低于对照组（P<0.05）。治疗后两组血清IFN-γ、IL-2水平均高于治疗前,且观察组高于对照组（P<0.05）。结论：慢性HBV感染患者存在肝纤维化水平上升、肝功能受损及Th1/Th2细胞失衡,恩替卡韦联合常规护肝治疗可有效纠正患者的Th1/Th2细胞失衡,减轻患者的肝纤维化,改善其肝功能。     

HIV Controllers Maintain a Population of Highly Efficient Th1 Effector Cells in Contrast to Patients Treated in the Long Term

HIV controllers are rare individuals who spontaneously control HIV replication in the absence of antiretroviral therapy. To identify parameters of the CD4 response that may contribute to viral control rather than merely reflect a persistently low viremia, we compared the T helper profiles in two groups of patients with more than 10 years of viral suppression: HIV controllers from the Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO18 cohort (n = 26) and efficiently treated patients (n = 16). Cells specific for immunodominant Gag and cytomegalovirus (CMV) peptides were evaluated for the production of 10 cytokines and cytotoxicity markers and were also directly quantified ex vivo by major histocompatibility complex (MHC) class II tetramer staining. HIV controller CD4(+) T cells were characterized by a higher frequency of gamma interferon (IFN-γ) production, perforin(+)/CD107a(+) expression, and polyfunctionality in response to Gag peptides. While interleukin 4 (IL-4), IL-17, and IL-21 production did not differ between groups, the cells of treated patients produced more IL-10 in response to Gag and CMV peptides, pointing to persistent negative immunoregulation after long-term antiretroviral therapy. Gag293 tetramer-positive cells were detected at a high frequency (0.12%) and correlated positively with IFN-γ-producing CD4(+) T cells in the controller group (R = 0.73; P = 0.003). Tetramer-positive cells were fewer in the highly active antiretroviral therapy (HAART) group (0.04%) and did not correlate with IFN-γ production, supporting the notion of a persistent immune dysfunction in HIV-specific CD4(+) T cells of treated patients. In conclusion, HIV controllers maintained a population of highly efficient Th1 effectors directed against Gag in spite of a persistently low antigenemia, while patients treated in the long term showed a loss of CD4 effector functions.     

Reproductive Hormones in the Control of Th1/Th2 Cytokine Balance

Individual and combined effects of chorionic gonadotropin (CG), estradiol, and progesterone on the production of IFNψ and IL-4 by human peripheral blood lymphocytes was studied in vitro together with certain intracellular mechanisms underlying the hormonal effects. High CG dose (100 IU/ml) proved to significantly decrease IFNψ level in the T cell culture supernatant, although this effect was not observed at the background of steroid hormones. In contrast, progesterone (100 ng/ml) increased IFNψ production by activated T lymphocytes but proved inefficient in a physiological combination with CG and estradiol. IL-4 production was almost doubled by all studied hormones and their combinations, which considerably decreased the IFNψ/IL-4 ratio in the culture. Inhibition analysis employing blockers of cAMP-dependent protein kinase (H-89) and L-type calcium channels (verapamil) as well as an antagonist of progesterone nuclear receptors (RU-486) demonstrated that the inhibitory (for IFNψ) and stimulatory (for IL-4) effects of CG were mediated by cAMP, while the effects of steroid hormones on the production of these cytokines were realized through genomic and non-genomic mechanisms (the latter mechanisms were largely mediated by L-type calcium channel regulation). Overall, the studied reproductive hormones could efficiently regulate synthesis of the main Th1 (IFNψ) and Th2 (IL-4) cytokines by T lymphocytes and seem to play the key role in changing the pregnancy-specific pattern of secreted cytokines.__________Translated from Izvestiya Akademii Nauk, Seriya Biologicheskaya, No. 3, 2005, pp. 273–280.Original Russian Text Copyright © 2005 by Kuklina, Shirshev.     

沙门菌- 斑马鱼感染模型用于Th1/Th2 免疫应答的研究

目的:通过构建斑马鱼成鱼感染模型,研究鼠伤寒沙门菌感染对机体Th1/Th2免疫应答的影响。方法:用不同剂量细菌口饲感染8月龄的斑马鱼成鱼,绘制3周生存率曲线。观察各剂量下对成鱼的感染情况,并用实时荧光定量聚合酶链式反应检测肝脏Th1、Th2型细胞相关基因和细胞因子的mRNA转录水平,计算Th2/Th1相对表达量比值。结果:用105 CFU感染2周斑马鱼全部存活,第15天开始出现死亡,且在3周后死亡率达到50%;感染后3周解剖发现,肝脏、脾脏和肠道有明显红肿和糜烂;肝脏Th1、Th2型细胞相关基因和细胞因子mRNA转录水平明显向Th2偏移。结论:用105 CFU鼠伤寒沙门菌口饲感染斑马鱼成鱼构建的模型,能反映机体感染和免疫功能变化,可用于研究体内Th1/Th2免疫应答,为进一步研究鼠伤寒沙门菌感染与免疫机制提供了很好的实验工具。     

Variation of Transaminases,HCV-RNA Levels and Th1/Th2 Cytokine Production during the Post-Partum Period in Pregnant Women with Chronic Hepatitis C

This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%), with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001) or as Type-B (34%), with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001) and this event was concomitant with an increase in Th1 cytokine levels (INFγ, P = 0.04; IL12, P = 0.01 and IL2, P = 0.01). On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INFγ and IL2, P<0.05) than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation.     

HIV感染者/AIDS病人高迁移率族蛋白1的表达及其临床意义

通过检测74例处于不同病期的HIV感染者/AIDS患者和10例健康对照者PBMCs中HMGB1 mRNA的表达水平及其外周血浆HMGB1、TNF-a和IL-2水平,比较各组之间表达水平的差异及其与CD4＋T淋巴细胞的关系.发现HMGB1 mRNA的表达水平及血浆HMGB1含量在AIDS病人组明显高于感染者组和正常对照组（P〈0.05）;AIDS患者经HAART治疗后疗效差组HMGB1 mRNA的表达水平及血浆HMGB1含量也明显高于疗效好组（P〈0.05）;而经HAART治疗后效果好且免疫功能恢复的患者HMGB1 mRNA的表达及血浆HMGB1含量均较治疗前明显下降（P〈0.05）;当CD4＋T细胞数低于200/μL时,血浆HMGB1含量以及PBMCs中HMGB1 mRNA表达水平与CD4＋T细胞数呈负相关.显示HMGB1在HIV/AIDS发病及病情进展过程中可能起重要作用,HMGB1血浆含量及PBMCs中HMGB1 mRNA的表达水平高低与HIV/AIDS患者病情轻重密切相关.     

Secure Surveillance of Antimicrobial Resistant Organism Colonization or Infection in Ontario Long Term Care Homes

Background

There is stigma attached to the identification of residents carrying antimicrobial resistant organisms (ARO) in long term care homes, yet there is a need to collect data about their prevalence for public health surveillance and intervention purposes.

Objective

We conducted a point prevalence study to assess ARO rates in long term care homes in Ontario using a secure data collection system.

Methods

All long term care homes in the province were asked to provide colonization or infection counts for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamase (ESBL) as recorded in their electronic medical records, and the number of current residents. Data was collected online during the October-November 2011 period using a Paillier cryptosystem that allows computation on encrypted data.

Results

A provably secure data collection system was implemented. Overall, 82% of the homes in the province responded. MRSA was the most frequent ARO identified at 3 cases per 100 residents, followed by ESBL at 0.83 per 100 residents, and VRE at 0.56 per 100 residents. The microbiological findings and their distribution were consistent with available provincial laboratory data reporting test results for AROs in hospitals.

Conclusions

We describe an ARO point prevalence study which demonstrated the feasibility of collecting data from long term care homes securely across the province and providing strong privacy and confidentiality assurances, while obtaining high response rates.     

Normocaloric Low Cholesterol Diet Modulates Th17/Treg Balance in Patients with Chronic Hepatitis C Virus Infection

Hepatitis C virus (HCV) infection is associated with hepatic and extrahepatic manifestations, including immunological disorders. Chronic Hepatitis C (CHC) is often characterized by cholesterol and lipid metabolism alterations, leading to hepatic steatosis. Cholesterol metabolism, in fact, is crucial for the viral life cycle. Recent works described that a higher dietary cholesterol intake is associated with the progression of HCV-related liver disease. CHC patients have increased levels of T helper 17 (Th17)-cells, a lymphocytic population involved in the pathogenesis of liver inflammation and autoimmune hepatitis. The balance between Th17 and regulatory T (Treg) cells is crucial for chronic inflammation and autoimmunity. Th17-cell differentiation is deeply influenced by the activation LXRs, nuclear receptors modulating cholesterol homeostasis. Moreover, HCV may affect these nuclear receptors, and cholesterol metabolism, through both direct and indirect mechanisms. On these bases, we hypothesized that modulation of cholesterol levels through Normocaloric Low Cholesterol Diet (NLCD) may represent an innovative strategy to reduce the progression of HCV infection, through the modulation of peripheral Th17/Treg balance. To this end, we performed a pilot study to investigate whether a Normocaloric Low Cholesterol Diet may be able to modulate Th17/Treg balance in patients affected by chronic HCV infection. After 30 days of NLCD CHC patients showed a significant reduction in Th17 cells frequency, which correlated with strong reduction of IL-17 and IL-22 serum levels. At the same time, we appreciated an increase in the percentage of Treg cells, thus improving Treg/Th17balance. Moreover, we observed an increased expression of LXRs and their target genes: SREBP-1c and ABCA-1. In conclusion, NLCD finely regulates Th17/Treg balance, improving immune system response in CHC patients. This study could pave the way for new treatments of CHC patients, suggesting that change in lifestyle could support the management of these patients, promoting well-being and possibly hindering disease progression.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02038387","term_id":"NCT02038387"}}NCT02038387     

The role of Th1/Th2 polarization in mucosal immunity

Mucosal immunity relies on the delicate balance between antigen responsiveness and tolerance. The polarization of T helper cells plays a key role in maintaining or disrupting this equilibrium.     

Characteristics of IgA Anti-HIV Antibodies in Plasma from Patients with HIV Infection

The concentration of total IgA and the specificity and molecular size of IgA anti-human immunodeficiency virus (HIV) type-1 antibodies in plasma obtained from individuals at different stages of HIV infection were analyzed. The concentration of total IgA in the plasma was not decreased even in the late stage of HIV infection, in contrast with those of total IgG and IgM. The IgA anti-HIV antibodies differed to the IgG anti-HIV antibodies in their specificity as determined by Western blotting. The IgA antibodies mainly bind to Env glycoproteins. The IgA anti-HIV antibodies in plasma were detected between IgG and IgM by gel filtration, suggesting the presence of polymeric IgA anti-HIV antibodies. These results indicate that the production of non-specific IgA in plasma is enhanced by unknown mechanisms in every stages of HIV infection, and suggest that IgA anti-HIV antibodies in plasma which are possibly polymeric and have unique specificity may play an important role in HIV infection.     

Influence of Th1/Th2 Cytokines and Nitric Oxide in Murine Systemic Infection Induced by Sporothrix schenckii

In an attempt to elucidate the effects of Sporothrix schenckii infection on the immune response, our laboratory has developed a murine model of disseminated sporotrichosis. Helper T cells can be further subdivided into Th1 and Th2 phenotypes. The differentiation of two subsets of T lymphocytes is driven by IL-12 and IL-4 cytokines, respectively. Th1 cells produce IFN-γ that activate macrophages and promote cell-mediated immunity. In addition, we found low levels of iNOS and NO production in the initial (1st and 2nd weeks) and final (9th and 10th weeks) periods of the infection, in contrast with the period of week 4 to 7 of elevated values. The determination of IFN-γ and IL-12 are in agreement with NO/iNOS detection, showing the presence of cellular immune response throughout the infectious process. However, the production of IL-4 shows an increase in levels after the 5th and 6th weeks suggesting a participation of Th2 response in this period as well. Regarding these results, the study demonstrated that in experimental sporotrichosis infection the cellular immune response participated throughout the period analyzed as a nitric oxide dependent mechanism. In contrast, the presence of Th2 response began in the 5th week, suggesting the participation of humoral immune response in advanced stages of sporotrichosis.     

微卡对支气管哮喘Th1/Th2类细胞因子失衡的调节作用

目的 探讨微卡对哮喘ThⅠ/Th2类细胞因子失衡的调节作用.方法 选取确诊的轻中度哮喘40例,所有患者深部肌肉注射微卡22.5μg,每2周1次,共8周,并在治疗前、治疗后1月、2月分别抽取静脉血3 ml检测IFN-γ和IL-4水平（ELISA法）.结果 微卡治疗后1月即可纠正失衡的IFN-γ/IL-4,其中以治疗后2月作用较明显,且未见明显的药物不良反应.结论 微卡通过调节失衡的Th1/Th2平衡而达到抗气道炎症作用,可作为哮喘的防治药物.     

T-Helper1/T-Helper2 Cytokine Imbalance in the Iris of Patients with Glaucoma

The mechanistic study of glaucoma pathogenesis has shifted to seeking to understand the effects of immune responses on retinal ganglion cell damage and protection. Cytokines mediate the biological effects of the immune system, and our previous study revealed an imbalance of T-helper (Th) 1-derived and Th2-derived cytokines in the serum of patients with glaucoma. In this study, we collected irises from normal individuals and patients with primary open-angle closure (POAG) or chronic angle-closure glaucoma (CACG). We used real-time polymerase chain reaction (PCR) to measure the expression of Th1 (interleukin (IL)-2, interferon-gamma (IFN-γ)), Th2 (IL-4, IL-6, IL-10), and Th3 (transforming growth factor-beta (TGF-β)) cytokines. We then performed immunohistochemical staining to characterize the localization of the upregulated cytokines in iris cryosections. We observed an upward trend in the expression of IL-2 and IFN-γ and a downward trend in IL-6 expression in the iris of POAG and CACG patients. Expression of TGF-β also increased. Immunohistochemistry revealed that IL-2 expression in POAG and CACG patients was localized in the anterior surface of the blood vessel wall in the stroma of the iris, in the cytoplasm of some cells, in the anterior epithelium, and in the posterior pigment epithelium. These findings indicate that immune status differed between the iris tissues of POAG and CACG patients and those of normal individuals. A T-helper cytokine imbalance may modulate the immune microenvironment in glaucomatous eyes and thus influence optic neuropathy.     

HIV and HCV Activate the Inflammasome in Monocytes and Macrophages via Endosomal Toll-Like Receptors without Induction of Type 1 Interferon

Innate immune sensing of viral infection results in type I interferon (IFN) production and inflammasome activation. Type I IFNs, primarily IFN-α and IFN-β, are produced by all cell types upon virus infection and promote an antiviral state in surrounding cells by inducing the expression of IFN-stimulated genes. Type I IFN production is mediated by Toll-like receptor (TLR) 3 in HCV infected hepatocytes. Type I IFNs are also produced by plasmacytoid dendritic cells (pDC) after sensing of HIV and HCV through TLR7 in the absence of productive pDC infection. Inflammasomes are multi-protein cytosolic complexes that integrate several pathogen-triggered signaling cascades ultimately leading to caspase-1 activation and generation pro-inflammatory cytokines including interleukin (IL)-18 and IL-1β. Here, we demonstrate that HIV and HCV activate the inflammasome, but not Type I IFN production, in monocytes and macrophages in an infection-independent process that requires clathrin-mediated endocytosis and recognition of the virus by distinct endosomal TLRs. Knockdown of each endosomal TLR in primary monocytes by RNA interference reveals that inflammasome activation in these cells results from HIV sensing by TLR8 and HCV recognition by TLR7. Despite its critical role in type I IFN production by pDCs stimulated with HIV, TLR7 is not required for inflammasome activation by HIV. Similarly, HCV activation of the inflammasome in monocytes does not require TLR3 or its downstream signaling adaptor TICAM-1, while this pathway leads to type I IFN in infected hepatocytes. Monocytes and macrophages do not produce type I IFN upon TLR8 or TLR7 sensing of HIV or HCV, respectively. These findings reveal a novel infection-independent mechanism for chronic viral induction of key anti-viral programs and demonstrate distinct TLR utilization by different cell types for activation of the type I IFN vs. inflammasome pathways of inflammation.     

宫颈癌患者高危型人乳头瘤病毒感染状况及其与阴道微环境、氧化应激水平及Th1/Th2细胞因子的关系研究

摘要 目的：探讨宫颈癌患者高危型人乳头瘤病毒（HR-HPV）感染与阴道微环境、氧化应激水平及辅助性T细胞（Th）1/Th2细胞因子的关系。方法：选择2016年1月至2021年12月石家庄市妇幼保健院收治的201例宫颈癌患者,根据是否发生HR-HPV感染将患者分为HR-HPV组（84例）和非HR-HPV组（117例）,另选择171例体检健康妇女为对照组。检测受试者阴道微环境（阴道清洁度、pH值、滴虫、霉菌、线索细胞和乳酸杆菌）,氧化应激指标[血清总氧化态（TOS）、总还原态（TAS）、氧化应激指数（OSI）]、Th1/Th2细胞因子[白细胞介素（IL）-2、IL-4、IL-6、IL-10、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）]水平,比较上述指标的差异。结果：201例宫颈癌患者,HR-HPV 感染84例,发生率为 41.79%。HR-HPV组和非HR-HPV组阴道清洁度异常、pH值异常、滴虫阳性、霉菌阳性、线索细胞阳性检出率高于对照组（P＜0.05）,乳酸杆菌阳性检出率低于对照组（P＜0.05）;HR-HPV组阴道清洁度异常、pH值异常检出率高于非HR-HPV组（P＜0.05）,乳酸杆菌阳性检出率低于非HR-HPV组（P＜0.05）。HR-HPV组血清TOS、OSI、IL-4、IL-6、IL-10水平高于对照组、非HR-HPV组（P＜0.05）,血清TAS、IL-2、TNF-α、IFN-γ低于对照组、非HR-HPV组（P＜0.05）。结论：宫颈癌患者存在较高的HR-HPV感染风险,HR-HPV感染可引起宫颈癌患者阴道微环境改变、氧化应激损伤以及Th1/Th2细胞因子紊乱,检测HR-HPV有助于评估宫颈癌患者阴道微生态和病情进展。     

Role of the β-Chemokine Receptors CCR3 and CCR5 in Human Immunodeficiency Virus Type 1 Infection of Monocytes and Microglia

Human immunodeficiency virus type 1 (HIV-1) infection in mononuclear phagocyte lineage cells (monocytes, macrophages, and microglia) is a critical component in the pathogenesis of viral infection. Viral replication in macrophages serves as a reservoir, a site of dissemination, and an instigator for neurological sequelae during HIV-1 disease. Recent studies demonstrated that chemokine receptors are necessary coreceptors for HIV-1 entry which determine viral tropism for different cell types. To investigate the relative contribution of the β-chemokine receptors CCR3 and CCR5 to viral infection of mononuclear phagocytes we utilized a panel of macrophage-tropic HIV-1 strains (from blood and brain tissue) to infect highly purified populations of monocytes and microglia. Antibodies to CD4 (OKT4A) abrogated HIV-1 infection. The β chemokines and antibodies to CCR3 failed to affect viral infection of both macrophage cell types. Antibodies to CCR5 (3A9) prevented monocyte infection but only slowed HIV replication in microglia. Thus, CCR5, not CCR3, is an essential receptor for HIV-1 infection of monocytes. Microglia express both CCR5 and CCR3, but antibodies to them fail to inhibit viral entry, suggesting the presence of other chemokine receptors for infection of these cells. These studies demonstrate the importance of mononuclear phagocyte heterogeneity in establishing HIV-1 infection and persistence.     

慢性牙周炎合并2型糖尿病患者龈沟液miR-21、miR-34a表达水平与牙周指标和Th1/Th2/Th17失衡的关系研究

摘要 目的：探讨慢性牙周炎（CP）合并2型糖尿病（T2DM）患者龈沟液微小核糖核酸（miR）-21、miR-34a表达水平与牙周指标和辅助性T细胞（Th）1/Th2/Th17失衡的关系。方法：选取2020年3月～2022年3月首都医科大学附属北京世纪坛医院口腔科收治的114例CP患者，根据是否合并T2DM分为CP合并T2DM组36例和单纯CP组78例，另选取60名健康体检者为对照组。对比三组牙周指标、龈沟液miR-21、miR-34a表达和外周血Th1、Th2、Th17、Th1/Th2/Th17、血清Th1、Th2、Th17相关细胞因子水平，采用Spearman相关性分析CP合并T2DM患者龈沟液miR-21、miR-34a表达与牙周指标和外周血Th1、Th2、Th17、Th1/Th2/Th17及其相关细胞因子水平的相关性。采用Pearson/Spearman相关性分析CP合并T2DM患者牙周指标与外周血Th1、Th2、Th17、Th1/Th2/Th17及其相关细胞因子水平的相关性。结果：对照组、单纯CP组、CP合并T2DM组菌斑指数（PLI）、牙龈出血指数（BI）、附着丧失（AL）、探诊深度（PD）依次增加，龈沟液miR-21和外周血Th2及血清白细胞介素（IL）-2、干扰素-γ（INF-γ）依次降低，龈沟液miR-34a和外周血Th1、Th17、Th1/Th2/Th17及血清IL-4、IL-10、IL-17、肿瘤坏死因子-α（TNF-α）依次升高（P＜0.05）。Spearman相关性分析显示，CP合并T2DM患者龈沟液miR-21表达与PLI、BI、AL、PD和外周血Th1、Th17、Th1/Th2/Th17及血清IL-4、IL-10、IL-17、TNF-α呈负相关，与外周血Th2和血清IL-2、INF-γ呈正相关（P＜0.05）；而miR-34a则与之相反。Pearson/Spearman相关性分析显示，CP合并T2DM患者PLI、BI、AL、PD与外周血Th1、Th17、Th1/Th2/Th17和血清IL-4、IL-10、IL-17、TNF-α呈正相关，与外周血Th2和血清IL-2、INF-γ呈负相关（P＜0.05）。结论：CP合并T2DM患者龈沟液miR-21低表达和miR-34a高表达，与牙周状况差有关，可能通过调节Th1/Th2/Th17失衡参与CP合并T2DM进展。