RESUMO
Objective:To explore the effect of Aryl hydrocarbon receptor (AhR) activated dendritic cell (DC) on T helper cell 17 (Th17) differentiation in primary biliary cholangitis (PBC) patients.Methods:Per-ipheral blood samples of 10 patients with PBC and 10 healthy people were collected. CD14 + mononuclear cells were isolated and induced to differentiate to DCs. After stimulated by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD), these DCs were co-cultured with the na?ve CD4 + T cells. Then, the proliferation activity of T cells was detected by Cell Counting Kit-8 (CCK-8) and cytokines related to Th17 differentiation were detected by quantitative real-time-polymerase chain reaction (qRT-PCR) and enzyme-linked immuno sorbent assay (ELISA). Results:A large number of DCs were obtained, and the microscopic observation showed that the cells were enlarged in size, irregular in shape, and numerous protrusions on the surface. The CD11 and CD14 double positive cells accounted for 96.48%. After co-culture, the proliferation capacity of na?ve CD4 + T cells in the PBC group was significantly higher than that in the healthy control group. Absorbance ( A) value measured by CCK-8 method at 72 hours (1.02±0.04) was significantly higher than that at 24 hours (0.69±0.04) and 48 hours (0.82±0.04), and the difference was statistically significant ( LSD- t1=10.2, P<0.05; LSD- t2=6.3, P<0.05). The expression level of na?ve CD4 + T cells IL-17 in the PBC patients group was(1.24±0.40) higher than that in the healthy control group (0.61±0.18), and the difference was statistically significant ( t=3.90, P<0.05). The expression level of IL-22 (0.96±0.46) was also higher than that of the healthy control group (0.42±0.43), and the difference was statistically significant ( t=2.76, P<0.05). The expression of IL-22 in the culture supernatant of the PBC patients group was (77.4±2.9) ng/ml, significantly higher than that of the healthy control group (49.6±4.0) ng/ml, the difference was statistically significant ( t=5.58, P<0.01). The expression level of IL-17 (170.9±2.7) ng/ml was also higher than that of the healthy control group (130.6±7.1) ng/ml, and the difference was statistically significant ( t=9.10, P<0.05). Conclusion:DCs activated by AhR can promote the differentiation of Th17 and the production of related cytokines. Thus, DCs activated by AhR may promote the occurrence of PBC.
RESUMO
Objective:To investigate the clinical features of primary biliary cholangitis (PBC) with thyroid disease (TD) and the association between TD and PBC.Methods:From 2005 to 2017, clinical data of PBC patients from the affiliated hospital of Qingdao university were retrospectively analyzed. All PBC patients were divided into 2 groups according to whether they have TD. The general conditionsand clinical manife-stations in the two groups were analyzed. T-test, nonparametric test, Chi-square test and Fisher's exact test-swere applied to compare datain subgroups. Results:A total of 148 PBC patients were involved in to our study, of which 45 cases (30.4%) had TD. PBC patients with TD showed a higher incidence of Sj?gren's synd- rome (SS) (33.3% vs 17.5%, χ2=4.545, P=0.033). Moreover, there was a higher positive rate of anti-SP100 and anti-SSB antibody in PBC patients with TD (20.0% vs 5.8%, χ2=5.440, P=0.020; 20.0% vs 2.9%, χ2=10.087, P=0.001) compared with patients without. PBC patients without TD presented a higher incidence of abdominal distension and jaundice (29.1% vs 11.1%, χ2=5.629, P=0.018; 23.3% vs 8.9%, χ2=4.241, P=0.039) compared to patients with TD. The ratio of patients with elevated total bilirubin (TBiL), direct bilirubin (DBiL), or increased alkaline phosphatase (ALP) was higher in PBC without TD group(40.8% vs 17.8%, χ2=7.405, P=0.007; 43.7% vs 17.8%, χ2=9.147, P=0.002; 69.9% vs 51.1%, χ2=4.811, P=0.028). Correspondingly, PBC patients without TD was associated with a higher probability of cirrhosis and portal hypertension (40.8% vs 22.2%, χ2=4.731, P=0.030; 25.2% vs 8.9%, χ2=5.183, P=0.023). Conclusion:TD has no effect on the natural history of PBC. PBC patients with TD are associated with a lower probability of liver fibrosis, portal hypertension and cholestasis symptoms but a higher incidence of SS when compared with PBC patients without TD. Multi-disciplinary approach should be implemented to the mag-nagement of PBC.