Effect of the warming and heat-clearing method on the percentage of regulatory T lymphocytes/T helper 17 cells in rats with acute-on-chronic liver failure

Objective To investigate the effect of the warming and heat-clearing method on the percentage of regulatory T (Treg) /T helper 17 (Th17) cells in rats with acute-on-chronic liver failure (ACLF) and the mechanism of its anti-liver failure activity. Methods A total of 140 Sprague-Dawley rats were randomly divided into normal group, model group, heat-clearing group, warming group, and warming + heat-clearing group. A rat model of immune liver fibrosis was established by sensitization with bovine serum albumin, and then an ACLF model was established by D-galactosamine + lipopolysaccharide attack. Serum liver function parameters [alanine aminotransferase (ALT) and total bilirubin (TBil) ], liver pathological changes, and number of peripheral Treg and Th17 cells were observed within 24 hours, and Treg/Th17 ratio was calculated. One-way ANOVA was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. Results Compared with the normal group, the model group had significant increases in ALT and TBil at each time point (all P < 0. 01) , with the damage of lobular structure, bridging and piecemeal necrosis in hepatocytes, and inflammatory cell infiltration in the portal area. Compared with the normal group, the model group also had significant increases in the percentage of peripheral Treg and Th17 cells (P < 0. 01) , and the percentage of Th17 cells was higher than that of Treg cells; there was a significant reduction in Treg/Th17 ratio in the model group (P < 0. 01) . Compared with the model group, the heat-clearing group, the warming group, and the warming + heat-clearing group had significant reductions in ALT and TBil (P< 0. 05) , with a more complete lobular structure, patchy and spotted necrosis in hepatocytes, and mild fibrous tissue hyperplasia at the portal area; these three groups also had significant reductions in the percentage of peripheral Treg and Th17 cells (P < 0. 05) , and Th17 cells had a greater reduction than Treg cells; the warming + heat-clearing group had significantly greater reductions than the heat-clearing group and the warming group (P < 0. 05) . Conclusion〗 The warming and heat-clearing method can regulate Treg/Th17 imbalance in rats with ACLF and is one of the mechanisms of its anti-liver failure activity.