青藤碱联合甲氨蝶呤对RA患者外周血Treg及Th17细胞的影响及其临床意义  

Change of Treg and Thl7 cells in the blood of patients with Rheumatoid Arthritis treated with sinomenine and its relationship with clinical guideline

作　　者：周洁如[1] 邓筠[1] 李凝[1] 金敏[2,3] 宋广珠[2,3] 王佳怡[1] 申怡 张洁[1] 韩捷[1] 

机构地区：[1]上海市东方医院风湿免疫科,上海200120 [2]中国科学院上海生命科学研究院 [3]上海交通大学医学院健康科学研究院

出　　处：《现代免疫学》2013年第1期46-51,共6页Current Immunology

基　　金：上海市卫生局科研计划课题资助项目(20090Y79)

摘　　要：通过观察青藤碱(SN)联合甲氨蝶呤(MTX)治疗类风湿关节炎(RA)外周血中Treg及Th17的表达变化,探讨其治疗RA可能的作用机制。采用三色荧光染色流式细胞仪(FCM)检测20例RA患者治疗前后外周血及20例健康人外周血中CD4^+CD25^+Foxp3^+T细胞及Th17细胞含量,并与RA的各项临床指标变化做相关性分析。SN联合MTX治疗RA病人组各项临床症状及临床指标均见明显好转;与未治疗组相比,SN联合MTX治疗RA患者组外周血中CD4^+CD25^+Foxp3^+T细胞水平明显升高而Th17细胞含量明显降低(P<0.05);RA外周血中CD4^+CD25^+Foxp3^+T细胞及Th17细胞均与RA与疾病活动指数DAS28指数存在一定的相关性(p<0.05)。青藤碱治疗RA疗效确切,其治疗的机制可能与通过调节Treg与Th17细胞的含量变化有关。To observe the expression change of Treg and Thl7 cells in rheumatoid arthritis（RA）treated with sinomenine （SN） combined with methotrexate （MTX）, to investigate the possible mechanism of SN action in RA.. The CD4＋ CD25＋ FOXP3＋ T cell and Thl7 cell level in the periphera blood of 20 RA patients before and after treatment and 20 cases of healthy human were detected by fluorescence staining flow cytometry （ FCM ）. Results is that （1）RA group patients treated with SN combined with MTX shew significantly improved symptoms and clinical indicators compared with the untreated group; （2）CD4＋ CD25＋ FOXP3＋ T cells level in the peripheral blood of RA patients treated with SN combined with MTX were significantly lower while Th17 cells were significantly increased （ P〈0.05 ） compared with the untreated group; （3）the level of Treg and Th17 cells both have relationship with the levels of DAS28 score, which is with disease activity index of rheumatoid arthritis. SN have accurate curative effect on RA patient, its therapeutic mechanism may be related to its regulation effect on Treg and Thl7 cells content.

关 键 词：类风湿性关节炎 Treg细胞(CD4^+CD25^+Foxp3^+T细胞) TH17细胞 

分 类 号：R392.11[医药卫生—免疫学]