Effect of compound glycyrrhizin on Th17/Treg cells in children with Henoch-Schonlein purpura

Abstract:

Objective：To investigate the role of Th17/Treg and some cytokines imbalance in the pathogenesis of childhood Henoch-Schonlein purpura（HSP） and to further explore the clinical effectiveness and immunomodulatory effects of compound glycyrrhizin（GL） in HSP. Methods：Twenty-seven HSP patients were chose as GL-treated group，another 26 patients were used as conventional therapy group，and 25 age-and sex-matched healthy children were used as healthy controls. Intravenous injection of 0.5-2.0 ml/kg GL for 7 days was provided in GL-treated group on the basis of treatments in conventional therapy group. Blood samples of patients were ob－tained at the acute stage and after 7 days’ treatment.Postive cell rates of peripheral Th17 and Treg cells were detected by flow cytom－etry using intracellular staining. Serum levels of interleukin-17，interferon-γ，TNF-α，interferon inducible protein-10 were detected by ELISA. Results：①Clinical effectiveness：renal complications in GL-treated group were relieved and recurrence of HSP within 1 month was lower. ②Positive cell rate of Treg and Th17 cell：compared with that of healthy controls，the positive cell rate of Treg in GL-treated group was significantly down-regulated during acute phase（P=0.010） and was up-regulated after the treatment（P=0.059）. In conventional therapy group，positive cell rate of Treg was lower after the treatment compared with that before treatment and that of healthy control group（P=0.006，P=0.013）. The positive cell rate of Th17 in GL-treated group was significantly higher before the treat－ment compared with that after the treatment and that of conven－tional therapy group（P=0.024，P=0.013）. After the treatment，there was no difference in the positive cell rate of Th17 between GL-treated group and conventional therapy group（P=0.337）. The positive cell rate of Th17 in conventional therapy group was significantly higher before the treatment compared with that after the treatment（P=0.014）. ③Cytokines：Serum levels of IL-17 and IFN-γ were higher in GL-treated group and conventional therapy group than in healthy control group before the treatment（P=0.013，P=0.010）. There was no difference in serum levels of IL-17 and IFN-γ between GL-treated group after the treatment and healty control group（P=0.052，P=0.154）. There was no difference in serum levels of IL-17 and IFN-γ in conventional therapy group before and after the treatment（P=0.218，P=0.970）. Serum levels of TNF-α and IP-10 in GL-treated group were down-regulated after the treatment（P=0.011，P=0.037）. But no difference was detected in conventional therapy group before and after the treatment（P=0.247，P=0.709）. Conclusion：①GL could relieve the renal complications and decrease recurrence of HSP in a short period of time. ②Treg and Th17 might in part contribute to the process of HSP. ③GL could help to up-regulate Treg and down-regulate Th17，IL-17，IFN-γ，TNF-α，IP-10 level，thus regulating the Th17/Treg deviation and cytokine im－balance and alleviating cellular immunity in HSP.