Evaluation of Treg/Th17 balance on relative risk of acute exacerbation in patients with chronic obstructive pulmonary disease
10.3969/j.issn.1000-484X.2025.11.022
- VernacularTitle:Treg/Th17平衡对慢性阻塞性肺疾病患者急性加重相对危险性的评价
- Author:
Yan ZHANG
1
;
Liying SONG
;
Jianwei WANG
Author Information
1. 秦皇岛市北戴河医院急诊科,秦皇岛 066100
- Publication Type:Journal Article
- Keywords:
Chronic obstructive pulmonary disease;
Treg/Th17;
Cellular homeostasis;
Acute exacerbations;
Relative risk
- From:
Chinese Journal of Immunology
2025;41(11):2689-2694
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore influence of Treg/Th17 balance on relative risk of acute exacerbation in patients with chronic obstructive pulmonary disease(COPD).Methods:A prospective cohort study was used to select 246 patients with COPD treated in emergency department of Beidaihe Hospital from January 2021 to January 2023,who were divided into acute aggravation group(113 cases)and stable group(133 cases)according to GOLD guidelines.Clinical indicators and lung function levels of two groups were compared,and risk variables of acute exacerbation in COPD patients were analyzed by Logistic multivariate regression.Restricted cubic spline model was used to analyze correlation between Treg/Th17 level and acute exacerbation in COPD patients.A line graph model was constructed and validation based on risk factors.The model was stratified according to risk score of column graph by X-tile software,and clinical application value of model was further discussed.Results:①Th17,IL-17,IL-22,C-reactive protein change rate(ΔCRP),procalcitonin change rate(ΔPCT)and TGF-β1 levels in acute aggravation group were significantly higher than stable group,Treg and Treg/Th17 levels were lower than stable group(P<0.05);②Multivariate Logistic regression analysis found that Treg≤9.06%,Th17≥2.23%,Treg/Th17≤5.27,ΔPCT≥0.845,ΔCRP≥0.554,IL-17≥37.55 ng/L,IL-22≥14.14 ng/L,TGF-β1≥840.56 ng/L were risk factors for COPD patients with acute exacerbation(P<0.05);③Restricted cubic spline model analysis showed that Treg/Th17 level was correlated with COPD acute exacerbation(χ2=7.214,P=0.001),and there was a linear dose-response relationship(χ2=3.542,P=0.112);④A line graph prediction model was constructed based on the above eight risk factors and evaluation results showed that C-index before and after verification were 0.864 and 0.831,respectively;AUC before and after validation were 0.856 and 0.832,respectively,and correction curve before and after validation fitted well with ideal curve.Clinical decision curve showed that when threshold probability was 0.01～0.91,higher net benefit could be obtained by this model;⑤Risk stratification showed that inci-dence of acute exacerbation in high risk group was significantly higher than medium and low risk groups(χ2=6.056,P=0.013).Con-clusion:Monitoring changes in peripheral blood Treg/Th17 cell balance provides a high reference value for acute exacerbations in patients with COPD.
