肾虚型类风湿关节炎与B淋巴细胞人免疫球蛋白GFc段受体Ⅱb的相关性研究  

Correlation Research on the Expression of FcγRⅡb on B Cells and Rheumatoid Arthritis Patients of Shen Deficiency Syndrome

作　　者：廖黔华[1] 郭林凯[1] 罗十之[1] 赖若谷[1] 刘晓玲[1] 陈光星[1] 

机构地区：[1]广州中医药大学第一附属医院风湿病科,广州510405

出　　处：《中国中西医结合杂志》2013年第9期1203-1207,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.30873243);教育部新世纪优秀人才资助项目(No.NCET-08-0642)

摘　　要：目的探索B淋巴细胞(B细胞)人免疫球蛋白G Fc段受体Ⅱb(Fcgamma receptorⅡb,FcγRⅡb)的表达与肾虚型类风湿关节炎(rheumatoid arthritis,RA)的相关性。方法 RA患者43例,其中肾虚型26例,非肾虚型17例,采用流式细胞术检测外周血幼稚B细胞、记忆B细胞和前浆细胞表达FcγRⅡb的水平,分析压痛关节数、肿胀关节数、血沉(ESR)、类风湿因子(RF)和病情活动指数评分(DAS28)与B细胞分布及FcγRⅡb表达水平的相关性;另设健康志愿者对照21名。结果肾虚型RA外周血记忆B细胞及前浆细胞FcγRⅡb表达分别为(49.65%±15.86%)及(43.69%±22.57%),比健康对照组[(64.03%±6.01%)及(66.59%±10.18%)]显著下调(P<0.01);非肾虚型RA记忆B细胞FcγRⅡb表达[(52.70%±9.52%)]比健康对照组明显下调(P<0.01);肾虚型RA前浆细胞FcγRⅡb表达明显低于非肾虚组[(56.10%±17.05%)],差异有统计学意义(P<0.05);B细胞亚群FcγRⅡb表达与压痛关节数、肿胀关节数、ESR、RF和DAS28评分无相关性。结论肾虚型RA患者B细胞免疫失耐受可能与记忆B细胞及前浆细胞表达FcγRⅡb下调密切相关,肾虚型RA可能存在FcγRⅡb基因的异常从而导致自身免疫失耐受。Objective To study the correlation between the expression of Fcgamma receptor 11 b （Fc,yRI] b） on B cells and rheumatoid arthritis （RA） patients of Shen deficiency syndrome （SDS）. Methods There were 43 IRA patients, including 26 of SDS and 17 of non-SDS. The expression levels of Fch, RII b on na- ive B cells, memory B cells, and plasma blasts in the peripheral blood were detected by flow cytometry. The numbers of tender joints, numbers of swollen joints, erythrocyte sedimentation rate （ESR）, rheuma- toid factor （RF）, and disease activity score （DAS28）, the correlation between the distribution of B cells and the expression level of FcγRⅡb in IRA patients were analyzed. Besides, another 21 healthy volunteers were recruited as the control group. Results The expression level ofFcγRⅡb was 49.65% ＋15.86% on memory B cells and 43.69% ±22.57% on plasma blasts in RA patients of SDS, significantly down-regulated when compared with those of the control group （64.03% ±6.01%, 66.59% ±10. 18%, P 〈0.01 ）. The ex- pression level of FcγRⅡb on memory B cells of RA patients of non-SDS was down-regulated more obvious- ly when compared with that of the control group （52.70% ±9.52% versus 64.03% ±6.01%, P 〈0.01 ）. The expression level of FcγRⅡb on plasma blasts was obviously lower in RA patients of SDS than in RA pa- tients of non-SDS （56.10% ±17.05%,P 〈0.05）. The expression level of FcγRⅡb on memory B cells was not correlated with numbers of tender joints, numbers of swollen joints, ESR, IRF, or DAS28. Conclusions The defective immunological tolerance of B cells in RA patients of SDS might be closely correlated with down-regulation ofFcγRⅡb on memory B cells and plasma blasts. There might exist genetic abnormality of FcγRⅡb gene in RA patients of SDS, thus inducing loss of autoimmunity tolerance.

关 键 词：类风湿关节炎 肾虚型 B淋巴细胞 Fc段受体Ⅱb 

分 类 号：R259[医药卫生—中西医结合]