Detection of Treg/Th17 cells and related cytokines in peripheral blood of chronic hepatitis B patients combined with thrombocytopenia and the clinical significance

Changes of regulatory T (Treg) cells and Th17 cells, and related cytokines in peripheral blood of patients with chronic hepatitis B combined with thrombocytopenia were investigated to explore the relationship with treatment outcomes. A total of 45 chronic hepatitis B patients combined with thrombocytopenia were selected in Heilongjiang Provincial Hospital from June 2015 to December 2016. All patients were treated with prednisolone acetate + gamma globulins for 60 days. Treg cells and Th17 cells in peripheral blood were detected by flow cytometry, and IL-10, TGF-beta, IL-17, IL-21 and IL-22 in peripheral blood were detected by ELISA before and after treatment. No significant differences in the percentages of Treg and Th17, and levels of IL-10, TGF-beta, IL-17, IL-21 and IL-22 were found in non-responders (n=17, platelets <100x10(9)/1) before and after treatment (P>0.05). After treatment, percentage of Treg was significantly increased (higher than that of non-responders) and percentage of Th17 was significantly decreased (lower than that of non-responders) in responders (P<0.05). In addition, serum levels of IL-10 and TGF-beta were significantly increased (higher than that of non-responders) and serum levels of IL-17, IL-21 and IL-22 were significantly decreased (lower than that of non-responders) in responders (P<0.05). The results showed that after treatment, the number of Treg cells was increased, the number of Th17 cells was decreased, the levels of anti-inflammatory factors IL-10 and TGF-beta were increased, and levels of pro-inflammatory factors IL-17, IL-21 and IL-22 were decreased in chronic hepatitis B patients combined with thrombocytopenia, indicating the decreased autoimmune response and improved thrombocytopenia. The changes were closely related to the complete response.