title: The imbalance between regulatory and IL-17-secreting CD4⁺T cells in multiple-trauma rat.
abstract: BACKGROUND
  It has been well recognised that a deficit of numbers and function of CD4(+)CD25(+)Foxp3(+)cells (Treg) is attributed to the development of auto-immune diseases, inflammatory diseases, tumour and rejection of transplanted tissue; however, there are controversial data regarding the suppressive effect of Treg cells on the T-cell response in auto-immune diseases. Additionally, interleukin-17 (IL-17)-producing cells (Th17) have a pro-inflammatory role. The balance between Th17 and Treg may be essential for maintaining immune homeostasis and has long been thought as one of the important factors in the development/prevention of auto-immune diseases, inflammatory diseases, tumour and rejection of transplanted tissue, but their role in multiple trauma remains unclear.
  
  
  OBJECTIVE
  This study aims to investigate whether an imbalance of Treg and Th17 effector cells is characteristic of rats suffering from multiple trauma.
  
  
  METHODS
  Sixty Sprague-Dawley (SD) rats were randomly divided into three groups. The control group (n=20, group I) no received procedures (normal). The sham group (n=20, group II) only received anaesthesia, cannulation and observation. The bilateral femoral shaft fractures with haemorrhagic shock groups (n=20, group III). Rats in groups II and III were killed at the end of 4h after models were established. Peripheral blood samples were collected for assessment of Treg cells, Th17 cells and cytokines (IL-17, IL-6, IL-2, transforming growth factor beta (TGF-β)) and intestine tissue was collected for intestine histological analysis.
  
  
  RESULTS
  We observed decreased Treg/Th17 ratios in CD4(+)T cells in rats with multiple trauma and a strong inverse correlation with disease activity (intestinal histological scores).
  
  
  CONCLUSIONS
  We suggest a role for immune imbalance in the pathogenesis and development of multiple trauma. The alteration of the index of Treg/Th17 cells likely indicates the therapeutic response and progress in the clinic.
authors.affiliation: Institute of Orthopaedics, Chinese PLA Beijing Army General Hospital, Dongcheng District, Nanmencang No. 5, Beijing 100700, China. Electronic address: unparalleledling@163.com.
authors.forename: Heling
authors.initials: H
authors.lastname: Dai
authors.forename: Tiansheng
authors.initials: T
authors.lastname: Sun
authors.forename: Zhi
authors.initials: Z
authors.lastname: Liu
authors.forename: Jianzheng
authors.initials: J
authors.lastname: Zhang
authors.forename: Meng
authors.initials: M
authors.lastname: Zhou
mesh_terms: D000818:Animals; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D002478:Cells, Cultured / Q000276:immunology; D051858:Forkhead Transcription Factors / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000473:pathology; D020381:Interleukin-17 / Q000378:metabolism*; D007376:Interleukin-2 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D009104:Multiple Trauma / Q000276:immunology* / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D016212:Transforming Growth Factor beta / Q000378:metabolism
chemical_list: D051858:Forkhead Transcription Factors; C500522:Foxp3 protein, rat; D020381:Interleukin-17; D007376:Interleukin-2; D015850:Interleukin-6; D016212:Transforming Growth Factor beta
keywords: Cytokine; Foxp3; Multiple trauma; Regulatory T cells; Th17 cells