T细胞疫苗治疗系统性红斑狼疮的初步临床研究  

A pilot study of T cell vaccination in systemic lupus erythematosus

作　　者：穆荣[1] 戴振鹏[2] 栗占国[1] 高晓明[2] 

机构地区：[1]北京大学人民医院风湿免疫科,100044 [2]北京大学医学部免疫学系

出　　处：《中华内科杂志》2004年第8期568-571,共4页Chinese Journal of Internal Medicine

基　　金：北京大学医学部"985工程"学科建设基金资助项目

摘　　要：目的 探讨T细胞疫苗治疗系统性红斑狼疮(SLE)的安全性及其疗效。方法 分离SLE患者外周血中的T淋巴细胞,克隆自身反应性T细胞,制备T细胞疫苗,以80 Gy的γ射线照射后,取1×107细胞皮下注射,并分别于首次免疫后第2、6、8周重复免疫。结果 在未增加激素及免疫抑制剂用量的前提下,全部6例接受T细胞疫苗治疗的患者,临床症状和实验室指标均有不同程度改善,SLE病情活动指数下降,未出现明显不良反应,总T细胞及CD4+、CD8+ T细胞亚群在正常范围。随访20～27个月,疗效明确。结论 初步结果表明,T细胞疫苗治疗SLE是一种比较安全而有效的方法,可能是部分SLE患者新的治疗途径。Objective Autoreactive T cells play a critical role in pathogenesis of systemic lupus erythematosus (SLE). Immunization with inactivated autoreactive T cells (T cell vaccination) may activate the idiotype anti-idiotypic network to deplete specific subsets of autoreactive T cells involved in SLE. We conducted a pilot clinical trial of T cell vaccination to investigate the efficiency and safety of T cell vaccination in treatment of SLE. Methods Autoreactive T cell clones were derived from peripheral blood mononuclear cells of 6 SLE patients. After irradiated with 80 Gyγ radiation, 1×107 T cells were inoculated subcutaneously at 0, 2, 6, 8 week respectively. The patients were followed up for 20-27 months, and monitored for clinical characteristics and side effects from the vaccination. Results The clinical manifestations and laboratory abnormalities were improved after inoculation without increasing the dose of corticosteroids and immunosuppressants in most patients. SLEDAI score were decreased remarkably. Proliferative responses against the T cell vaccine were observed in 4/6 patients. No side effect was noticed and CD3+, CD4+ and CD8+ T cell were all in normal ranges after the vaccination and during the follow-up period. Conclusion The results of this pilot study indicate that T cell vaccination is a safe and effective treatment in SLE patients.

关 键 词：T细胞疫苗 治疗 系统性红斑狼疮 安全性 

分 类 号：R593.241[医药卫生—内科学] R392[医药卫生—临床医学]