Expression and clinical significance of plasma interleukin 17 and interleukin 21 in patients with immune related hematopathy / 中国综合临床

ABSTRACT

Objective To investigate the changes of expression levels of interleukin?17(IL?17) and interleukin?21( IL?21) secreted by helper T cells 17 before and after treatment of three immune?related hematological diseases,and to explore the clinical significance??Methods Sixty patients with IRH admitted to the Department of Hematology,the First Affiliated Hospital of Hebei North University from May 2017 to October 2018 were selected as subjects??They were divided into aplastic anemia group (24 cases),immune thrombocytopenia group (20 cases) and autoimmune hemolytic anemia group (16 cases)??Another 60 healthy volunteers who had physical examination in our hospital at the same time were selected as the control group??In the 3 IRH groups,patients were treated with glucocorticoids or immunologic agents,and the control group was given vitamin C??At the time of initial diagnosis,2 weeks and 3 months after IRH treatment,all the patients in the 4 groups were examined for blood?related indicators,and the therapeutic effects of different stages and the plasma levels of IL?17 and IL?21 in the peripheral blood of the 4 groups before and after treatment were compared??Results At the initial diagnosis,the plasma IL?17 levels in the aplastic anemia group,immune thrombocytopenia group and autoimmune hemolytic anemia group were ((196??52± 17??46), (185??69± 18??19),(126??13 ± 11??22) ng／L),respectively,which were higher than those in control group ((72??36± 10??21) ng／L), the differences were statistically significant ( all P＜0??05)??The plasma IL?21 levels in the aplastic anemia group,immune thrombocytopenia group and autoimmune hemolytic anemia group were ((136??82±20??16),(145??92±22??18),(119??66±12??69)) ng／L,respectively,which were higher than those in control group (( 84??01 ± 9??87) ng／L), and the differences were statistically significant ( all P＜0??05)??After 2 weekly treatment,the levels of IL?17 and IL?21 in the 3 groups were significantly lower than those at the first visit (all P＜0??05)??After 3 months of treatment,the levels of IL?17 and IL?21 in the 3 groups were also significantly lower than those at the first diagnosis ( IL?17: aplastic anemia group ( 84??69 ±12??15) ng／L,immune thrombocytopenia group (90??56±11??64) ng／L,autoimmune hemolytic anemia group (62??83±5??68) ng／L;IL?21: aplastic anemia group ( 96??28± 8??84) ng／L,immunological thrombocytopenia group (103??21±10??62) ng／L,autoimmune hemolytic anemia group (78??64±9??68) g／L),and the difference were statistically significant ( all P＜0??05)??There was no significant change in the control group ( 83??84 ±9??95) ng／L(P＞0??05)??After 3 months of treatment,the total effective rates of treatment in the three groups (the aplastic anemia group 83??33%( 20／24), immunological thrombocytopenia group90??00%( 18／20), autoimmune hemolytic anemia group 75??00%( 12／16)) were higher than 2 weekly treatment ( aplastic anemia group 41??67%( 10／24 ), immunological thrombocytopenia group 40??00%( 8／20 ), autoimmune hemolytic anemia group25??00%(4／16)),and the differences were statistically significant( all P ＜0??05)??Conclusion The changes of plasma IL?17 and IL?21 levels are helpful to indicate the occurrence and progression of immune?related hematopathy,to find therapeutic targets and to improve prognosis,which has important clinical significance in the clinical diagnosis,prognosis and treatment of different types of IRH??