Levels of Th22 and Th17 cells, Cytokines and miR-200 levels in children with systemic lupus erythematosus complicated with infection

OBJECTIVE To investigate the levels of T helper cells (Th) 22, Th17, cytokines and micrornas (miR)-200 in children with systemic lupus erythematosus co-infection, and to analyze the predictive value of each index.

METHODS One hundred and fifty children with systemic lupus erythematosus (SLE) co-infection admitted to Shengjing Hospital Affiliated to China Medical University from Mar. 2020 to Apr. 2023 were selected as the infection group, 150 children with SLE without infection admitted to the hospital during the same period were selected as the non-infection group, and 150 healthy children underwent health examination were selected as the control group. Children in the infection group were followed up for one year and divided into the good prognosis group and poor prognosis group according to whether there was organ damage. The relative expression levels of Th22, Th17 cells, interleukin-17, IL-22 and miR-200 in the three groups, the good and the poor prognosis group were compared. The predictive value of Th22, Th17 cells, IL-17, IL-22 and miR-200 levels in children with systemic lupus erythematosus co-infection was analyzed by receiver operating characteristic (ROC) curve.

RESULTS The level of miR-200 in the infection group was (1.14±0.27), which was lower than in the non-infection group(1.36±0.33) and the control group (P < 0.05). The levels of Th22, Th17 cells, IL-17 and IL-22 in the infection group were (6.19±1.24), (1.76±0.38), (21.16±4.48) and (52.79±7.94), respectively, which were higher than those in the non-infection group and the control group (P < 0.05). The miR-200 in the poor prognosis group was (0.91±0.22), lower than that in the good prognosis group (P < 0.05), and the Th22, Th17 cells and IL-17, IL-22 in the poor prognosis group were (6.86±1.35), (1.97±0.36), (24.36±5.03) and (58.51±7.45), respectively, higher than those in the good prognosis group (P < 0.05). The AUC of the combined detection of relative expression levels of Th22, Th17 cells, IL-17, IL-22 and miR-200 for the prognosis of children with systemic lupus erythematosus co-infected was 0.897, with the sensitivity of 82.60% and specificity of 81.70%, which was higher than that of the index alone.

CONCLUSIONS Th22, Th17 cells and cytokines are highly expressed in children with systemic lupus erythematosus co-infection, while miR-200 is lowly expressed. The detection of the above indexes is effective in predicting the prognosis of children with systemic lupus erythematosus co-infections, and the combined predictive value is the highest.