类风湿关节炎患者外周血CD4^＋T细胞CD25及CD127的表达  

Study on expressions of CD25 and CD127 in CD4^＋ peripheral T lymphocytes of patients with rheumatoid arthritis

作　　者：黄志祥[1] 郑奔容[1] 李天旺[1] 卢应民 古洁若[1] 韩晓燕[2] 

机构地区：[1]中山大学附属第三医院风湿科,广州510630 [2]中山大学附属第三医院中心实验室,广州510630 [3]广东省普宁市人民医院内科

出　　处：《中华医学杂志》2009年第35期2476-2480,共5页National Medical Journal of China

基　　金：广东省自然科学基金（05001703）

摘　　要：目的探讨类风湿关节炎（RA）患者外周血调节性T细胞（Tregs）比例的变化情况，了解Tregs变化在RA发病及炎症活动中的意义。方法采用流式细胞仪三色荧光抗体标记法分别对25例RA患者和31名健康志愿者（HV）的外周血淋巴细胞进行CD4、CD25及CD127标记，分析比较RA患者组与HV组问淋巴细胞中CD4^＋CD25^＋、CD4^＋CD25^high、CD4^＋CD25^＋CD127^-及CD4^＋CD25^high CD127^-细胞比例的差异情况，并将RA组相应细胞比例与RA疾病活动性评分（DAS28-4）、压痛关节数、肿胀关节数、晨僵时间、医生和患者对疾病活动性的整体评价（VAS）、血红细胞沉降率、C-反应蛋白行相关分析。结果RA组外周血淋巴细胞中，CD4^＋CD25^＋CD127^-和CD4^＋CD25^highCD127^-细胞占CD4^＋T淋巴细胞的百分率分别为（2．53±0．85）％和（0．91±0．32）％，而HV组则分别为（3.22±0.97）％和（1．25±0．41）％。CD4^＋CD25^＋CD127^-和CD4^＋CD25^highCD127^-细胞比例在RA组均明显低于HV组，其组间差异均有统计学意义（均P〈0．05）；另外，RA患者CD4^＋CD25^＋CD127和CD4^＋CD25^highCD127^-T细胞比例均与DAS28-4及压痛关节数存在负相关（P〈0．05），CD4^＋CD25^highCD127^-T细胞还与肿胀关节数及患者VAS存在负相关（P〈0．05）。结论RA患者外周血淋巴细胞存在Tregs比例的降低，Tregs数量的异常可能是RA发病及炎症活动的重要影响因素。Objective To study the proportion of regulatory T cells （Tregs） in peripheral blood of patients with rheumatoid arthritis （ RA ） and investigate the significance of Tregs change in the incidence and inflammatory activity of RA. Methods Three-color fluorescence flow cytometry was used to detect the CD4, CD25 and CD127 markers in the peripheral blood lymphocytes of 25 RA patients and 31 healthy volunteers （HVs）. The proportions of CD4^＋CD25^＋, CD4^＋ CD25^high, CD4^＋ CD25^＋ CD127^- and CD4^＋ CD25^＋high CD127^- cells were compared between the two groups and correlation analysis was conducted between Tregs and disease activity indices which including disease activity score （DAS28-4）, tender joint count （TJC）, swollen joint count （SJC）, time of morning stiffness, patient＇s global assessment of disease activity on a 100 mm VAS by doctor and patients, erythrocyte sedimentation rate and C-reactive protein. Results The proportions of CD4^＋ CD25^＋ CD127^- and CD4^＋ CD25^high CD127^- cells in CD4^＋ peripheral T lymphocytes were （2. 53 ±0. 85）% and （0. 91±0. 32）% respectively in RA group,while they were （3.22 ±0. 97）% and （1.25± 0. 41 ）% in HV group. Both of the proportions of CD4^＋ CD25^＋ CD127^- and CD4^＋ CD25^high CD127^- cells were lower in RA group comparing with HV group, and both were significantly different between the two groups （ P 〈 0. 05 ）. Correlation analysis indicated significant negative correlations of the proportions of CD4^＋CD25^＋ CD127^- and CD4^＋ CD25^high CD127^- cells with DAS28-4 and TJC （ P 〈 0.05 ） , furthermore, CD4^＋ CD25^highCD127^- T cells still showed significant negative correlation with the SJC and patient＇s global assessment of disease activity on a 100 mm VAS by patients （P 〈 0. 05 ）. Conclusion The proportion of Tregs decreased in peripheral blood lymphocytes of patients with RA and the abnormality of Tregs may play an important role in the incidence and inflammatory activity of RA.

关 键 词：类风湿关节炎 调节性T细胞 CD127 

分 类 号：R686[医药卫生—骨科学]