糖皮质激素对系统性红斑狼疮患者CD4^+ CD25^+ CD127^(dim/-)T淋巴细胞GITR表达及凋亡的影响  

Effects of glucocorticoids on the expression of GTIR and apoptosis of the CD4^+ CD25^+ CD127^(dim/-)T cells in patients with systemic lupus erythematosus

作　　者：潘云[1] 李向培[1] 孙甲峰[1] 王俐[1] 陈竹[1] 厉小梅[1] 陶金辉[1] 钱龙[1] 张宏[1] 

机构地区：[1]安徽医科大学附属省立医院风湿免疫科,合肥230001

出　　处：《北京大学学报（医学版）》2012年第2期215-220,共6页Journal of Peking University:Health Sciences

基　　金：安徽省自然科学基金项目(090413129)资助~~

摘　　要：目的:探讨糖皮质激素(glucocorticoids,GC)对系统性红斑狼疮(systemic lupus erythematosus,SLE)患者CD4+CD25+CD127dim/-T淋巴细胞(Treg)糖皮质激素诱导肿瘤坏死因子受体(glucocorticoid-induced tumor necrosisfactor receptor,GITR)的表达及Treg细胞凋亡的影响,并分析其临床价值。方法:分离28例SLE患者(SLEDAI评分<10分为13例,SLEDAI评分≥10分为15例)及12例正常对照者外周血CD4+CD25+CD127dim/-T细胞,分别加入地塞米松5×10-2mg/L后培养48 h,流式细胞仪检测培养前后的GITR表达和Treg细胞的凋亡率,并分析其与临床和实验室指标的相关性。结果:SLE患者Treg细胞上GITR表达和凋亡率均高于正常对照,差异有统计学意义(P=0.016;P=0.049)。加入地塞米松前后SLE患者Treg细胞上GITR表达差异无统计学意义(P>0.05);但正常对照组在加入地塞米松后Treg细胞GITR表达明显增加(P=0.034)。与未加入地塞米松相比,加入地塞米松后SLE患者Treg细胞凋亡率减少,差异有统计学意义(P=0.033);而正常对照组Treg细胞凋亡率增加,差异亦有统计学意义(P=0.012)。SLE患者Treg细胞GITR表达比例与SLEDAI评分成正相关,与补体C3成负相关。结论:GITR在SLE患者Treg细胞上呈病理性表达,其可能作为SLE疾病活动的免疫学指标之一;GC对SLE的治疗作用可能通过抑制Treg细胞的异常凋亡而并非抑制GITR的表达。Objective：To investigate the expression of glucocorticoid-induced tumor necrosis factor receptor（GITR） and apoptosis of CD4＋CD25＋CD127dim/-T cells of the patients with systemic lupus erythematosus（SLE）,and to analyze its clinical value.Methods： A total of 28 patients with a diagnosis of SLE according to the American College of Rheumatology（ACR） 1997 criteria were included in the study.The SLE patients were divided into active group（SLEDAI≥10） and inactive group（SLEDAI10） according to the SLE disease activity index（SLEDAI）.Active group included 15 patients and inactive group 13 patients.Clinical and laboratory data of the patients with SLE were recorded.In this study 12 normal volunteers without history of autoimmune diseases were also included.Peripheral blood CD4＋CD25＋CD127dim/-T cells were isolated by magnetic beads sorting.We classified them into two subgroups： the blank group and the therapeutic dose group（dexamethasone dose was 5×10-2 mg/L and the peripheral blood CD4＋CD25＋CD127dim/-T cells with dexamethasone were cultured for 48 hours）.The expressions of GITR and AnnexinⅤ were analyzed by flow cytometry before and after the culture.The correlations between GITR levels,apoptosis rates of these subsets and the clinic,laboratory parameters of SLE were analyzed.Results： GITR levels and apoptosis rates in the patients with SLE were signi-ficantly higher than those in the normal control group（P=0.016;P=0.049）.The expression levels of GITR on Treg cells between the blank group and the therapeutic dose group were found be of no significant difference in the patients with SLE（P0.05）,but in the normal group,the expression levels of GITR in the therapeutic dose group were higher than those in the blank group（P=0.034）.After adding dexamethasone,the apoptosis rates of Treg cells were decreased in the patients with SLE,the difference was statistically significant（P=0.033）;But in the normal control group,the apoptosis rate of Treg cells was higher in the

关 键 词：糖皮质激素 红斑狼疮 系统性 糖皮质激素类诱导TNFR相关蛋白质 T淋巴细胞 调节性 细胞凋亡 

分 类 号：R593.24[医药卫生—内科学]