Clinical significance of Th17/Treg and associated cytokines in peripheral blood in chronic hepatitis C patients with liver cirrhosis

Objective To investigate the clinical significance of Th17/Treg imbalance and changes in associated cytokines in chronic hepatitis C (CHC) patients with liver cirrhosis.Methods A total of 96 CHC patients who visited The First People's Hospital of Tianmen from May 2014 to May 2016 were enrolled and divided into CHC group with 54 CHC patients, LC group with 42 CHC patients with LC, and HC group with 40 healthy persons who underwent physical examination.Flow cytometry was used to measure the percentages of Th17 and Treg cells in peripheral blood, ELISA was used to measure the serum levels of interleukin-6 (IL-6) , interleukin-10 (IL-10) , interleukin-17 (IL-17) , and transforming growth factor-β (TGFβ) , and the levels of HCV RNA, aspartate transaminase (AST) , alanine aminotransferase (ALT) , and total bilirubin (TBil) were also measured.An analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for comparison between any two groups;the chi-square test was used for comparison of categorical data between groups;Pearson correlation analysis was also performed.Results Compared with the HC group and the CHC group, the LC group had significantly higher percentages of Th17 cells (5.97%±0.84% vs 2.39%±0.46%/4.75%±0.67%, F=312.95, P<0.001) and Treg cells (3.14%±0.72% vs 1.72%±0.53%/2.81%±0.87%, F=47.21, P<0.001) in peripheral blood, as well as a significantly higher Th17/Treg ratio (1.90±0.52 vs 1.39±0.12/1.69±0.45, F=17.34, P<0.001) .The LC group also had significantly higher serum levels of IL-6, IL-17, IL-10, and TGF-β than the HC group and the CHC group (F=160.38, 574.11, 23.90, and 36.97, all P<0.001) .The percentages of Th17 and Treg cells, Th17/Treg ratio, and levels of IL-17, IL-6, IL-10, and TGF-β were significantly positively correlated with ALT and AST levels (ALT:r=0.633, 0.525, 0.631, 0.931, 0.841, 0.372, and 0.343, all P<0.05;AST:r=0.597, 0.502, 0.564, 0.873, 0.813, 0.365, and 0.337, all P<0.05) , and the percentages of Th17 and Treg cells and levels of IL-6, IL-17, and TGFβ were also significantly positively correlated with TBil level (r=0.344, 0.231, 0.401, 0.339, and 0.307, all P<0.05) .Conclusion Th17 and Treg cells and associated cytokines may be closely associated with the development and progression of CHC and LC and have certain significance in the prevention and treatment of CHC patients with LC.