干燥综合征患者外周血程序性死亡分子-1／程序性死亡配体-1共刺激分子的表达及临床意义  

The expression and clinical significance of programmed death-1/programmed death ligands-1 in perip- heral blood in patients with primary Sjogren＇s syndrome

作　　者：徐婷[1] 吴敏[1] 蔡明渊[1] 朱然然[2] 孙茹蓉[1] 喻少波[1] 张佩蓉[1] 徐正[1] 

机构地区：[1]江苏省常州市第一人民医院苏州大学第三附属医院风湿免疫科,213003 [2]苏州大学医学生物技术研究所

出　　处：《中华风湿病学杂志》2013年第5期318-322,共5页Chinese Journal of Rheumatology

基　　金：江苏省常州市卫生局重大科技项目（ZD201108）

摘　　要：目的探讨原发性干燥综合征（pSS）患者外周血单个核细胞（PBMCs）上程序性死亡分子（PD）-1和程序性死亡配体（PDL）-1的表达及生物学意义。方法应用流式细胞仪（FCM）检测62例Dss患者及15名健康对照者的PBMCs上CD4＋PD．1＋、CD8＋PD．1＋、CDl4＋PDL．1＋及CDl9＋PDL-1＋的表达率，详细记录各患者的临床资料及实验室结果，并分析PD-1／PD—L1协同抑制分子与pss患者的临床特点及疾病活动的相关性。统计学处理采用t检验，组间相关性分析采用直线相关分析。结果laSS患者外周血CD4＋PD-1＋表达（29±8）％显著高于健康对照组（23±4）％，活动期（34±8）％显著高于缓解期（27±6）％（P均〈O．01），但治疗前后差异无统计学意义；CD8＋PD．1＋表达（21±7）％显著高于健康对照组（17±6）％（P均〈0．05），活动期与缓解期、治疗前后差异均无统计学意义；pSS患者CDl4＋PDL-1＋表达（17±10）％显著低于健康对照组（24±12）％（P均〈0．05），活动期与缓解期、治疗前后差异无统计学意义；pSS患者CDl9＋PDL-1＋与健康对照组、活动期与缓解期、治疗前后差异均无统计学意义。CD4＊PD-1＋与CDl4＋PDL-1＋之间呈负相关。pSS患者CD4＋PD-1＋表达率与抗双链（ds）DNA、类风湿因子（RF）及红细胞沉降率（ESR）呈正相关，CD8＋PD-1＋表达率与免疫球蛋白（Ig）G、血小板呈正相关，CDl4＋PDL-1＋与抗dsDNA抗体、RF及补体（C）4呈负相关，CD19＋PDL-1＋与C4呈负相关。pSS患者肾脏损伤组外周血CD8＋PD-1＋的表达率显著高于无损伤组，有关节炎表现组外周血CDl4＋PDL-1＋的表达率显著低于无表现组。结论Dss患者外周血PD-1／PDL-1共刺激分子存在异常，与病情活动相关，可能参与到psS疾病中肾脏损伤及关节损伤，在pss的发病机制中起到重要作用，为pSS的治疗提供新的治疗靶点。Objective To investigate the expression and clinical significance of programmed death （PD）-I/ programmed death ligands （PDL）-I in patients with primary Sjsgren＇s syndrome （pSS）. Methods The method of flow cytometry was used to measure the expression of CD4＋PD-1＋, CD8＋PD-1＋, CD14＋PDL-1＋ and CD19＊PDL-1＋ in 62 patients with pSS and the test results were compared with those of 15 normal controls. The linear correlation analysis was adopted to evaluate the relationship between the expression of CD4＋PD-1＋, CD8＋PD-1 ＋, CD14＋PDL-1 ＋, CD19＋PDL-1 ＋ and clinical manifestations. Comparisons between groups were performed by t test. Results The expression of CD4＋PD-1＋ was significantly higher in pSS patients （29±8）% than in normal controls （23±4）% （P〈0.01）, and significantly higher in active pSS patients （34±8）% than inactive patients （27±6）% （P〈0.01）, and there was no significant difference between untreated pSS patients （31±7）% and treated patients （31±8）%. The expression of CD8＋PD-1＋ was significantly higher in pSS patients （21±7）% than in normal controls （17±6）% （P〈0.05）, and there was no significant difference between active pSS patients （20±9）% and inactive patients （22±6）%, as well as between untreated pSS patients （26±9）% and treated patients （19±4）%. The expression of CD14＋PDL-1＊ was significantly lower in pSS patients （17±10）% than in normal controls （24±12）% （P〈0.05）, and there was no significant difference between active pSS patients （16±9）% and inactive patients （17±10）%, as well as between untreated pSS patients（17±9）% and treated patients （16±15）%. There was no significant difference between pSS patients （16±6）% and normal controls （16±7）%, so was the difference between active pSS patients （16±3）% and inactive patients （16±7）%, and between untreated pSS patients （16±6）% and treated patients （18±8）% in the expressi

关 键 词：干燥综合征 单核细胞 程序性死亡分子-1 程序性死亡配体-1 

分 类 号：R593.2[医药卫生—内科学]