The dynamic changes and significance of T helper type 17 cells and cell-related cytokines in the peripheral blood of acute hepatitis B patients

Objective To investigate the expression of T helper type 17 cells (Th17) and cell-related cytokines, including interleukin (IL)-21, IL-22, IL-23 in the peripheral blood of different clinical stages of patients with acute hepatitis B (AHB). Methods Ten cases of AHB patients were enrolled. The frequency of Th17 cells in the three clinical stages (i.e.acute phase, convalescent phase and resolved phase) were detected by flow cytometry. IL-21, IL-22 and IL-23 were measured by enzyme-linked immunosorbent assay (ELISA). Control group was composed of ten healthy subjects. The comparison between the two groups was done by t test and the differences among multiple groups were compared by one way ANOVA. Pearson correlation analysis was used for correlation analysis. Results The frequency of Th17 in healthy controls was (0.68±0.29)%, while those in acute phase, convalescent phase and resolved phase of AHB patients were(18.22±4.13)%, (3.14±1.90)% and (3.31±0.95)%, respectively. The differences between the two groups were significant (t=13.405, 4.047 and 8.342, respectively; all P<0.01). The levels of IL-21, IL-22 and IL-23 in healthy controls were (42.00±6.95), (315.89±96.16) and (11.95±6.95) ng/L, respectively. Those in acute phase of AHB patients were (575.39±47.01), (648.44±47.12) and (38.29±4.68) ng/L, respectively, those in convalescent phase were (366.50±33.74), (405.04±47.12) and (25.10±4.69) ng/L, respectively, while those in resolved phase of AHB patients were (46.62±8.28), (365.94±45.62) and (15.29±4.69) ng/L, respectively. Compared with healthy controls, t values of the levels of IL-21 in three different phases of AHB patients were 35.497, 29.792 and 1.354 with P value of <0.01, <0.01 and 0.193, respectively; those of IL-22 were 9.820, 2.632 and 1.487 with P value of <0.01, 0.021 and 0.161, respectively; those of IL-23 were 9.944, 4.961 and 1.260 with P values of <0.01, <0.01 and 0.226, respectively. After comparison of IL-21, IL-22 and IL-23 among three different phase of AHB, F values were 622.784, 107.772 and 60.743 with all P values less than 0.01, respectively. The levels of IL-21, IL-22 and IL-23 were all positively correlated with the serum ALT level in acute phase (r=0.655, 0.666 and 0.673, respectively; all P<0.05). Correlation analysis demonstrated that the frequency of Th17 was positively correlated with the levels of IL-21, IL-22 and IL-23 in acute phase(r=0.879, 0.866 and 0.879, respectively; all P<0.01). The frequency of Th17 was positively correlated with the level of IL-21 in the resolved phase. No correlations between the remaining groups were confirmed. Conclusion The expressions of Th17 and cell-related cytokines, including IL-21, IL-22 and IL-23 decline with the recovery of AHB. Key words: Hepatitis B, acute; Th17; IL-21; IL-22; IL-23