The change of high mobility group protein B1, helper T cell 17 and regulatory T cell change in patients with acute severe cholecystitis and its correlation analysis / 中国医师进修杂志

ABSTRACT

Objective:To investigate the levels of plasma high mobility group protein B1 (HMGB1), helper T cell 17 (Th17) and regulatory T cell (Treg) in patients with acute severe cholecystitis and its correlation.Methods:One hundred and twenty patients with acute severe cholecystitis were selected as the cholecystitis group, and 120 healthy subjects during the same period were selected as the control group from January 2017 to December 2018 in Zhejiang Xin′an International Hospital. Enzymelinked immunosorbent assay was used to determine the levels of HMGB1, interleukin (IL)-17 and transforming growth factor-β (TGF-β). Flow cytometry was used to determine Th17 and Treg cell levels. The patients in cholecystitis group received percutaneous transhepatic cholecystectomy combined with laparoscopic surgery, and the levels of above mentioned were detected and compared.Results:The levels of HMGB1 and Th17 cells in the cholecystitis group were higher than those in the control group, the level of Treg cells was lower than that in the control group [(9.84 ± 0.82) μg/L vs. (4.12 ± 0.75) μg/L, (4.02 ± 0.31)% vs. (1.53 ± 0.24)%, (3.16 ± 0.65)% vs. (6.17 ± 0.73)%], and the differences were statistically significant ( P<0.01). The level of IL-17 in the cholecystitis group was higher than that in the control group, the level of TGF-β was lower than that in the control group [(37.46 ± 4.73) ng/L vs. (18.52 ± 4.32) ng/L, (4.32 ± 0.64) μg/L vs. (6.84 ± 0.67) μg/L], and the differences were statistically significant ( P<0.01). The serum HMGB1 level in patients with acute severe cholecystitis was positively correlated with Th17( r=0.564) and IL-17( r=0.602), was negatively correlated with Treg ( r=- 0.518) and TGF-β( r=- 0.563), and the differences were statistically significant ( P<0.01). In the cholecystitis group, after treatment the levels of HMGB1, Th17, IL-17 were decreased [(4.76 ± 0.75) μg/L vs. (9.84 ± 0.82) μg/L, (1.82 ± 0.24)% vs. (4.02 ± 0.31)%,(16.27 ± 4.28) ng/L vs. (37.46 ± 4.73) ng/L], the levels of Treg, TGF-β were increased [(5.58 ± 0.73)% vs. (3.16 ± 0.65)%, (5.23 ± 0.55) μg/L vs. (4.32 ± 0.64) μg/L], and the differences were statistically significant ( P<0.01). Conclusions:Patients with acute severe cholecystitis have elevated levels of HMGB1 and Th17 in plasma and have decreased levels of Treg. The levels of HMGB1, Th17 and Treg cells can reflect the therapeutic effect. HMGB1 is closely related to the imbalance of Th17/Treg.