重型再生障碍性贫血患者Th3细胞、调节T细胞数量和转化生长因子β1的水平  

Quantitative changes of peripheral type 3 T helper cell and CD4^+ CD25^+ regulatory T cells and serum TGF-β1 levels in the patients with severe aplastic anemia

作　　者：涂梅峰[1,3] 邵宗鸿[2] 刘鸿[1] 何广胜[1] 付蓉[2] 施均[1] 白洁[1] 曹燕然[1] 王化泉[1] 邢莉民[1] 崔振珠[1] 孙娟[1] 贾海蓉[1] 陈辉树[1] 薛艳萍[1] 杨崇礼[1] 

机构地区：[1]中国医学科学院,中国协和医科大学血液学研究所,血液病医院 [2]天津医科大学总医院血液肿瘤科 [3]北京大学临床肿瘤学院北京肿瘤医院内科,100036

出　　处：《中华血液学杂志》2006年第11期753-756,共4页Chinese Journal of Hematology

基　　金：国家自然科学基金资助项目(30470749)

摘　　要：目的测定重型再生障碍性贫血(SAA)患者外周血辅助性T细胞Ⅲ型(Th3)、CD+ CD25+调节T细胞(Tr)数量和血浆中转化生长因子β1(TGF-β1)水平,探索SAA患者细胞免疫耐受被打破的机制。方法用流式细胞术检测20例发病期和10例免疫抑制治疗(IST)后恢复期的SAA患者外周血表达TGF-β1的CD4+细胞(Th3)数量;用流式细胞术检测12例新发SAA患者、9例IST后未恢复和10例恢复期SAA患者的Tr数量,并与12名正常对照比较,分析其与CD3+CD4+、CD3+CD8+细胞及CD3+CD4+／CD3+CD8+细胞比值的相关性;采用ELISA法检测25例SAA患者血浆中TGF-β1水平,分析其与Th3细胞、血小板计数的相关性。结果正常对照组Th3细胞、CD8+TGF-β1+细胞及Th3／CD8+TGF-β1+细胞比值分别为(5．10±0．91)％,(4．93±0．97)％、1．20±0．19;SAA发病组分别为(1．33±0．20)％,(1．72±0．24)％,1．00±0．25,Th3细胞、CD8+TGF-β1+细胞比例明显下降(P< 0．01和P<0．05);SAA恢复组分别为(2．19±0．21)％,(2．07±0．33)％,1．71±0．52,Th3细胞、CD8+ TGF-β1+细胞比例均较SAA发病组升高,但仍明显低于正常对照组(P值均<0．05);正常对照组Tr比例为(8．25±1．96)％;新发SAA组为(3．32±0．81)％,明显低于正常对照组;SAA治疗后未恢复组Tr为(7．09±1．84)％,较新发SAA组明显升高(P<0．05),与正常对照组差异无统计学意义;SAA恢复组Tr为(7．49±1．27)％,较新发SAA组明显升高(P<0．05),与正常对照组差异无统计学意义;SAA患者Tr与CD3+CD4+细胞、CD4+／CD8+细胞比值呈正相关(r=0．855,P<0．01:r=0．729,P< 0．01),而与CD3+CD8+细胞呈负相关(r=-0．488,P<0．05);正常对照组血浆TGF-β1水平为(11．06±0．49)μg／L,SAA组为(2．49±0．51)μg／L,较正常对照组明显下降(P<0．01);SAA组血浆TGF-β1水平与Th3细胞呈正相关(r=0．396,P<0．05),与血小板水平呈正相关(r=0．701,P<0．01)。结论SAA患者外周血Th3细胞、Tr数量和血浆中TGF-β1水平下降可能导致Objective To explore the mechanism of autoimmune intolerance in severe aplastic an mia （SAA）. Methods By FACS, the quantity of peripheral TGF-β producing CD4 ^＋ T cells （Th3） in 20 SAA patients at active phase, 10 SAA patients at recovery phase and 12 normal controls were detected. The percentages of peripheral CD4 ^＋ CD25 ^＋regulatory T cells in 12 SAA patients at active phase, 9 non-responded patients after IST, 6 patients at recovery phase and 12 normal controls were counted, and its correlation with the percentages of CD3 ^＋ CD4 ^＋ and CD3^＋ CD8^＋ cells were analyzed. By enzyme linked immunosorbent assay （ELISA）, the serum level of TGF-β1 in 25 SAA patients and 13 normal controls was measured and its corre- lation with peripheral platelets counts was analyzed. Results The percentages of peripheral Th3 cells, CD8 ^＋ TGF-β1 ＋cells and the ratio of Th3/ CD8^＋ TGF-β1 ^＋ in controls were （5.10 ±0.91 ）% , （4.93±0.97）% and 1.20 ± 0.19 respectively, and those in SAA patients at active phase were（ 1.33 ± 0.20 ）%, （1.72 ±0.24） % , 1.00 ± 0.25, respeetively（P 〈 0.01 ,P 〈 0.05 ）. The aforementioned parameters of SAA patients at recovery phase increased to （2.19 ±0.21 ）% , （2.07 ±0.33）% and 1.71±0.52 respectively, but the percentages of Th3 cells and CD8^＋ TGF-β1^＋ were still lower （ P 〈 0.05 ）. The percentage of Th3 cells was decreased in the SAA patients. The percentage of peripheral CD4^＋ CD25^＋ T regulator cells in peripheral blood of controls was （8.25±1.96）%, and that in SAA patients was （3.32 ± 0.81 ）%. The percentages of CD4 ^＋ CD25 ^＋ T cells of 9 non-responded patients and 10 patients at recovery phase were increased to （7.09 ± 1.84 ） % and （7.49 ± 1.27 ） % respectively, being no difference from those of normal controls. The percent- age of CIM ^＋ CD25^＋ T cells of SAA patients was positively related to the percentage of CD3 ^＋ CD4^＋ cells and the ratio of CD3 ^＋ CD4 ^＋ to CD3 ^＋ CD

关 键 词：贫血 再生障碍性 T淋巴细胞亚群 转化生长因子Β 

分 类 号：R556[医药卫生—血液循环系统疾病]