炎症性肠病患者外周血淋巴细胞功能相关抗原-1的表达与临床特征的关系  

Relationship between Peripheral Lymphocyte Function Associated Antigen-1 and Clinical Features in Patients with Inflammatory Bowel Disease

作　　者：华梦超 孙瑾[2] 于成功[1,2] 

机构地区：[1]南京大学医学院附属鼓楼医院消化科,210008 [2]南京医科大学鼓楼临床学院消化科

出　　处：《胃肠病学》2013年第11期667-671,共5页Chinese Journal of Gastroenterology

基　　金：国家自然科学基金面上项目(81170359)资助

摘　　要：背景:淋巴细胞功能相关抗原-1(LFA-1)是β2整合素家族成员,广泛表达于几乎所有白细胞中。LFA-1/ICAM-1共刺激分子在炎症性肠病(IBD)的发生中发挥重要作用。目的:研究IBD患者外周血LFA-1的表达变化,分析其与患者临床特征的相关性。方法:纳入20名健康体检者和93例IBD患者(其中CD 66例,UC 27例),流式细胞术检测外周血CD4+细胞和外周血单个核细胞(PBMC)中LFA-1的平均荧光强度(MFI),并分析其与疾病活动度、疾病部位、疾病行为和临床指标的相关性。结果:CD和UC患者PBMC中LFA-1的MFI均显著低于健康对照组(P<0.05)。CD和UC患者缓解期外周血CD4+细胞和PBMC中LFA-1的MFI与活动期无明显差异。空回肠型CD患者外周血CD4+细胞和PBMC中LFA-1的MFI较回肠型、结肠型、上消化道型CD患者明显升高(P<0.05);狭窄型CD患者外周血CD4+细胞中LFA-1的MFI显著高于非狭窄非穿透型CD患者(P<0.05);有2种肛周病变的CD患者外周血CD4+细胞和PBMC中LFA-1的MFI显著高于有1种肛周病变者(P<0.05)。ESR、血清CRP与CDAI评分、Mayo评分呈正相关(P<0.05);HCT、Hb、血清ALB与CDAI评分、Mayo评分呈负相关(P<0.05)。结论:LFA-1参与IBD的发病过程,与CD疾病行为的关系尤为密切,但用于判断疾病活动度尚需进一步研究。Background： Lymphocyte function associated antigen-1 （LFA-1） is a member of β2 integrin family and is expressed on the surface of leukocytes. LFA-1/ICAM-1 co-stimulatory molecule is presumed to play a pivotal role in the pathogenesis of inflammatory bowel disease （IBD）. Aims： To investigate the expression of LFA-1 in patients with IBD and to analyze the correlation between LFA-1 and clinical features. Methods： Twenty healthy controls and 93 IBD patients, including 66 CD and 27 UC, were enrolled in this study. The mean fluorescence intensity （MFI） of LFA-1 in peripheral CD4＋ ceils and peripheral blood mononuclear cells （PBMC） was detected by flow cytometry, and relationships with disease activity, disease location, disease behavior and clinical indices were analyzed. Results ： MFI of LFA-1 in PBMC was significantly lower in CD and UC patients than that in normal controls （P 〈 0.05 ）. MFI of LFA-1 in CD4＋ cells and PBMC in remission stage of CD and UC patients was not significantly different with that in active stage. MFI of LFA-1 in CD4＋ cells and PBMC in patients with lesions in jejunum-ileum was significantly higher than that with lesions in ileum, colon and upper digestive tract （ P 〈 0.05）. MFI of LFA-1 in CD4＋ cells in stenosis CD patients was significantly higher than that in non-stenosis and non- penetrating CD patients （ P 〈 0.05 ）, and was significantly higher in CD4＋ cells and PBMC in CD patients with 2 kinds of perianal lesion than that with 1 kind of perianal lesion （P 〈 0.05 ）. Positive correlations were found between CDAI, Mayo score and ESR, CRP （P 〈 O. 05）. Negative correlations were found between HCT, Fib, ALB and CDAI, Mayo score （P 〈 0.05）. Conclusions： LFA-1 plays an important role in the development of IBD, especially for disease behavior of CD. However, further study is needed for using LFA-1 to evaluate the disease activity of IBD.

关 键 词：炎症性肠病 CROHN病 结肠炎 溃疡性 淋巴细胞功能相关抗原1 疾病活动度 

分 类 号：R574[医药卫生—消化系统]