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

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          Abstract

          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 + γ globulins for 60 days. Treg cells and Th17 cells in peripheral blood were detected by flow cytometry, and IL-10, TGF-β, 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-β, IL-17, IL-21 and IL-22 were found in non-responders (n=17, platelets <100×10 9/l) 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-β 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-β 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.

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          The plasticity of human Treg and Th17 cells and its role in autoimmunity.

          CD4(+) T helper cells are a central element of the adaptive immune system. They protect the organism against a wide range of pathogens and are able to initiate and control many immune reactions in combination with other cells of the adaptive and the innate immune system. Starting from a naive cell, CD4(+) T cells can differentiate into various effector cell populations with specialized function. This subset specific differentiation depends on numerous signals and the strength of stimulation. However, recent data have shown that differentiated CD4(+) T cell subpopulations display a high grade of plasticity and that their initial differentiation is not an endpoint of T cell development. In particular, FoxP3(+) regulatory T cells (Treg) and Th17 effector T cells demonstrate a high grade of plasticity, which allow a functional adaptation to various physiological situations during an immune response. However, the plasticity of Treg and Th17 cells might also be a critical factor for autoimmune disease. Here we discuss the recent developments in CD4(+) T cell plasticity with a focus on Treg and Th17 cells and its role in human autoimmune disease, in particular multiple sclerosis (MS). Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Thrombocytopenia associated with chronic liver disease.

            Thrombocytopenia (platelet count <150,000/microL) is a common complication in patients with chronic liver disease (CLD) that has been observed in up to 76% of patients. Moderate thrombocytopenia (platelet count, 50,000/microL-75,000/microL) occurs in approximately 13% of patients with cirrhosis. Multiple factors can contribute to the development of thrombocytopenia, including splenic platelet sequestration, bone marrow suppression by chronic hepatitis C infection, and antiviral treatment with interferon-based therapy. Reductions in the level or activity of the hematopoietic growth factor thrombopoietin (TPO) may also play a role. Thrombocytopenia can impact routine care of patients with CLD, potentially postponing or interfering with diagnostic and therapeutic procedures including liver biopsy, antiviral therapy, and medically indicated or elective surgery. Therapeutic options to safely and effectively raise platelet levels could have a significant effect on care of these patients. Several promising novel agents that stimulate TPO and increase platelet levels, such as the oral platelet growth factor eltrombopag, are currently in development for the prevention and/or treatment of thrombocytopenia. The ability to increase platelet levels could significantly reduce the need for platelet transfusions and facilitate the use of interferon-based antiviral therapy and other medically indicated treatments in patients with liver disease.
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              Suppression of antigen presentation by IL-10.

              Regulated antigen presentation to immune cells determines the effectiveness of an immune response. IL-10 is an immunosuppressive cytokine that regulates immune responses by inhibiting the ability of APCs to present antigens to T cells in a variety of ways. The mechanisms of IL-10-mediated immunosuppression include interference in TLR-mediated or IFNγ-mediated dendritic cell (DC) and macrophage activation as well as direct induction of genes that suppress APC function. In this review we will discuss current studies exploring the molecular mechanisms by which IL-10 suppresses APC function.
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                Author and article information

                Journal
                Exp Ther Med
                Exp Ther Med
                ETM
                Experimental and Therapeutic Medicine
                D.A. Spandidos
                1792-0981
                1792-1015
                August 2018
                14 June 2018
                14 June 2018
                : 16
                : 2
                : 1328-1332
                Affiliations
                [1 ]Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150036, P.R. China
                [2 ]Department of Hematology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
                [3 ]Department of Infectious Diseases, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
                [4 ]Department of Hematology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150036, P.R. China
                Author notes
                Correspondence to: Dr Yanhua Su, Department of Hematology, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang, Harbin, Heilongjiang 150036, P.R. China, E-mail: suyanhua1287431@ 123456163.com
                Article
                ETM-0-0-6311
                10.3892/etm.2018.6311
                6090452
                9aab75e0-ca2e-44fb-a005-285c1f0695b5
                Copyright: © Wang et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 25 August 2017
                : 23 May 2018
                Categories
                Articles

                Medicine
                chronic hepatitis b,thrombocytopenia,regulatory t cells,th17 cells
                Medicine
                chronic hepatitis b, thrombocytopenia, regulatory t cells, th17 cells

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