人类白细胞抗原-B27阳性急性前葡萄膜炎患者外周血中Th细胞亚群的表达及意义  

Expression and significance of peripheral blood T helper cells in human leucocyte antigen-B27-anterior uveitis patients

作　　者：邹文军[1] 武志峰[1] 项晓丽[1] 孙松[1] 张洁[1] 

机构地区：[1]南京医科大学附属无锡第二医院眼科,无锡214002

出　　处：《中华实验眼科杂志》2012年第12期1118-1121,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：无锡市社会发展科技指导性计划项目（CSZO1012）

摘　　要：背景人类白细胞抗原-B27（HLA-B27）阳性急性葡萄膜炎是非感染性葡萄膜炎常见的类型之一，Th17细胞是在人类自身免疫性疾病中发挥重要作用的细胞因子，而Th17细胞与HLA—B27阳性急性前葡萄膜炎的关系鲜见报道。目的研究HLA—B27相关性急性前葡萄膜炎患者外周血中辅助性T淋巴细胞亚群（Thl、Th2、Th17）的表达及意义。方法采用前瞻性队列研究设计。收集2011年1—10月于无锡第二医院眼科就诊的HLA—B27阳性急性前葡萄膜炎患者22例，并收集性别和年龄匹配的健康体检者16名作为正常对照组。采用流式细胞术检测受检者外周血中Thl、Th2、Th17细胞的表达比例，采用免疫比浊法检测患者外周血中c反应蛋白（CRP）质量分数，并对患者的病情程度进行评分，采用Spearman秩相关分析法对患者外周血中Thl、Th2、Th17细胞比例与病情严重程度评分或CRP质量分数的关系进行统计分析。结果HLA—B27阳性急性前葡萄膜炎患者外周血中-γ干扰素（IFN-γ）CD4＋Thl细胞比例、CD4＋白细胞介素-17（IL-17）＋Th17细胞比例均明显高于正常对照组，差异均有统计学意义[（23．11±9．69）％VS．（16．00±4．26）％，P=0．041；（3．96±2．92）％VS．（1．68±0．60）％，P=0．002]，而CD4＋IL4＋Th2细胞比例与正常对照组相比差异无统计学意义[（0．33±0．36）％VS．（0．56±O．34）％，P=0．122]。患者外周血Thl细胞比例与患者病情严重程度评分及CRP质量分数均无明显相关性（r=0．197，P=0．500；r=0．253，P=0．383）；Th2细胞比例与患者病情严重程度评分及CRP质量分数均无明显相关性（r=0．068，P=0．817；r=0．439，P=0．116）；Th17细胞比例与患者病情严重程度评分呈明显正相关（r=0．805，P=0．001），与患者CRP质量分数无显著相关性（r=0．226，P=0．436）。结论HLA—B27阳性急性前葡萄膜炎患者外周血中CD4＋Background Human leucocyte antigen （HLA）-B27-associated uveitis is one of the most common causes of non-infectious uveitis. T helper 17 （Thl7） ceils play an important role in human autoimmune diseases,but the pathology research on the production of Thl7 ceils in acute anterior uveitis patients positive for HLA- B27 was rarely reported. Objective The aim of this study was to investigate the expression and significance of the peripheral blood T helper cell subsets （ Thl , Th2, Thl7 ） in acute anterior uveitis patients positive for HLA-B27. Methods This study meets the criteria of the Helsinki Declaration. Informed consent was obtained from all the participants. A prospective cohort design was used in this study. Twenty-two patients with acute anterior uveitis positive for HLA-B27 were enrolled from Affiliated Second Hospital of Nanjing Medical University,and 16 normal healthy subjects with matched gender and age were enrolled as controls. The expression of interferon-＇,/ （IFN-＇y） , interleukin-4 （IL4） and IL-17 on lymphocytes （CD4~） in blood were assessed by flow cytometry, and immunoturbidimetry was used to detect the C reactive protein （CRP） level in blood. The degree of the severity of disease was evaluated by clinical scoring. The correlations between the percentage of IFN-~,＋Thl ,IL-4＊Th2 ,or IL-17~ Thl7 with clinical factors and CRP were analyzed. Results The percentages of IFN-~/＋Thl and IL-17＋Thl7 in theperipheral blood were （23.11±9.69） % and （3, 96±2.92） % in the patient group,showing a significant increase in comparison with （ 16.00±4.26）% and （1.68±0.60） % in the control group （P=0, 041 ,P=0. 002）. However,the IL-4＋Th2 level was not significantly different between the patient group （0. 33%±0. 36% ） and the control group （0.56% ±0. 34% ） （P=0. 122）. No significant correlations were found between the percentage of IFN-3,＋Thl with disease severity and CRP （ r = 0. 197, P = 0. 500 ; r = 0. 253, P = 0. 383 ） , between the p

关 键 词：急性前葡萄膜炎 人类白细胞抗原-B27 流式细胞术 辅助性T淋巴细胞亚群 免疫反应 

分 类 号：R773[医药卫生—眼科]