Objective:

2

To detect the expression levels of peripheral blood Treg/Th17 cells and related cytokines in patients with Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) with different traditional Chinese medicine (TCM) syndrome " Yanghuang-Yinyanghuang-Yinhuang"

in order to explore the cellular immunological characteristics of different TCM syndromes of liver failure.

Method:

2

The 32 cases of patients with HBV-ACLF in early

middle and late stages in line with the " Yanghuang-Yinyanghuang-Yinhuang" TCM syndrome grouping were selected. Flow cytometry was used to detect the frequency expression of Treg/Th17 cells in peripheral blood. The expression levels of interleukin-10(IL-10)

transforming growth factor-

β

(TGF-

β

)

interleukin-17A(IL-17A)

tumor necrosis factor-

α

(TNF-

α

) and interleukin-23(IL-23) were detected by cytometric bead array (CBA). The expressions of transcription factor forkhead box P3(FoxP3) and retinoid-related orphan nuclear receptor-

γ

t(ROR-

γ

t) mRNA were detected by Real-time PCR. The SPSS 20.0 software was applied in data statistics and processing to analyze the expression characteristics of Treg/Th17 cells and related cytokines in patients with different TCM syndrome types of HBV-ACLF.

Result:

2

The patients with HBV-ACLF Yanghuang syndrome were mainly distributed in the early stage of liver failure

those with Yinyanghuang syndrome were mainly distributed in the middle stage

and those with Yinhuang syndrome were distributed in the late stage. From Yanghuang syndrome

Yinyanghuang syndrome to Yinhuang syndrome

the frequency of Treg and Th17 cells gradually increased

and the differences among the groups were statistically significant (

P

<

0.05). From Yanghuang syndrome

Yinyanghuang syndrome to Yinhuang syndrome

Treg cytokines IL-10

TGF-

β

gradually increased

and the differences among the groups were statistically significant (

P

<

0.05). Th17 cytokines IL-17A

TNF-

α

IL-23 gradually increased

of which IL-17A were differences between Yanghuang syndrome and the Yinyanghuang syndrome

as well as Yanghuang syndrome and Yinhuang syndrome (

P

<

0.05). From Yanghuang syndrome

Yinyanghuang syndrome to Yinhuang syndrome

the expression of FoxP3 was gradually decreased

while that of ROR-

γ

t was gradually increased

and the differences among the groups were statistically significant (

P

<

0.01).

Conclusion:

2

There is a certain correlation between the different course of early

middle and late stages of HBV-ACLF and the distribution of TCM syndromes. The frequency of Treg and Th17 cells and the correlation of IL-17A

TGF-

β

and IL-10 with TCM syndrome differentiation are related

suggesting that Treg and Th17 cells have a certain reference value for the diagnosis of patients with HBV-ACLF and the syndrome differentiation of TCM syndromes.