Correlation of Treg/Th17 imbalance with IL-6, CD40L, and sTREM-1 in children with immune thrombocytopenic purpura and its diagnostic value
10.3760/cma.j.cn341190-20240718-00927
- VernacularTitle:免疫性血小板减少症患儿Treg/Th17失衡与IL-6、CD40L、sTREM-1的相关性及诊断价值
- Author:
Xiao ZHOU
1
;
Xiaoyun JIANG
;
Kaili ZHENG
Author Information
1. 金华市中心医院儿内科，金华 321000
- Publication Type:Journal Article
- Keywords:
Thrombocytopenia;
Immunity;
Interleukin-6;
T-lymphocytes，regulatory;
T-lymphocytes, helper-inducer;
Diagnosis;
Patient acuity
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(5):706-711
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To correlate the expression of interleukin-6 (IL-6), CD40 ligand (CD40L), and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) with regulatory T lymphocyte (Treg)/helper T lymphocyte 17 (Th17) in children with immune thrombocytopenic purpura (ITP) and to assess their combined diagnostic value.Methods:A retrospective study was conducted involving 80 children with ITP (ITP group) and 80 healthy children undergoing routine health screenings (control group) at Jinhua Central Hospital from February 2023 to February 2024. The levels of IL-6, CD40L, and sTREM-1, along with the Treg/Th17 ratio, were compared between the two groups and among children with different degrees of ITP severity. The correlations between IL-6, CD40L, and sTREM-1 and the severity of ITP, as well as the Treg/Th17 ratio were analyzed. Additionally, the diagnostic value of the combined tests was evaluated.Results:The levels of IL-6, CD40L, and sTREM-1 in the ITP group were (46.53 ± 8.69) ng/L, (6.51 ± 1.51), and (18.76 ± 3.72) ng/L, respectively. These values in the ITP group were significantly higher than those in the control group [(11.72 ± 1.58) ng/L, (4.31 ± 1.25), (8.07 ± 1.34) ng/L, t = 35.25, 10.04, 24.18, all P < 0.001]. The Treg/Th17 ratio in the ITP group was (1.34 ± 0.41), which was significantly lower than that in the control group [(13.56 ± 2.87), t = 37.70, P < 0.001]. In children with severe ITP, the levels of IL-6, CD40L, and sTREM-1 were (56.39 ± 11.70) ng/L, (9.62 ± 1.78), and (24.72 ± 4.81) ng/L, respectively. For those with moderate ITP, the levels were (45.41 ± 8.27) ng/L, (6.38 ± 1.40), and (17.69 ± 3.56) ng/L, respectively. In children with mild ITP, the levels were (37.04 ± 6.32) ng/L, (5.11 ± 1.32), and (14.50 ± 3.04) ng/L. The Treg/Th17 ratio in children with mild ITP was (0.95 ± 0.26), which was significantly lower than that in the moderate (1.37 ± 0.40) and severe (2.88 ± 0.56) groups. All differences were statistically significant among the three groups ( F = 23.98, 42.57, 37.15, 122.23, all P < 0.001). The levels of IL-6, CD40L, and sTREM-1 were positively correlated with the severity of ITP ( r = 0.565, 0.542, 0.538) and negatively correlated with the Treg/Th17 ratio ( r = -0.572, -0.536, -0.532), with all correlations being statistically significant (all P < 0.001). The receiver operating characteristic curve analysis indicated that the area under the curve values for the individual diagnoses of IL-6, CD40L, and sTREM-1 were 0.779, 0.750, and 0.763, respectively. In contrast, the area under the curve value for the combined diagnosis was 0.951, which was greater than that for each individual marker ( Z = 1.924, 2.137, 2.015, P = 0.037, 0.026, 0.031). Conclusions:The levels of IL-6, CD40L, and sTREM-1 in children with ITP are substantially correlated with the severity of ITP and the Treg/Th17 ratio, demonstrating notable diagnostic efficacy for ITP. Notably, the combination of IL-6, CD40L, and sTREM-1 greatly enhances diagnostic value.
