EB病毒感染对系统性红斑狼疮临床表现及Th1/Th2平衡的影响  

Clinical manifestation of EBV infection on systemic lupus erythematosus and effect of Th1/Th2 balance

作　　者：王晓冰[1] 叶文静[1] 张智勇[1] 朱小春[1] 王良兴[2] 

机构地区：[1]温州医科大学附属第一医院风湿免疫科,浙江温州325000 [2]温州医科大学附属第一医院呼吸科,浙江温州325000

出　　处：《温州医学院学报》2013年第12期779-783,共5页Journal of Wenzhou Medical College

基　　金：温州市科技计划项目(Y20100287)

摘　　要：目的 :探讨系统性红斑狼疮(SLE)与EB病毒(EBV)感染的相关性及EBV感染对SLE患者Th1/Th2平衡的影响。方法:收集90例SLE患者(SLE组)及70例健康对照者(对照组)血液标本,用实时荧光定量PCR法测EBV-DNA特异性片段来检测EBV-DNA的阳性率,ELISA法检测血清中IFN-γ和IL-4的表达水平,四色流式细胞术检测Th1、Th2细胞数和Th1/Th2比值。结果:SLE组EBV-DNA阳性率明显高于对照组(P<0.01);SLE患者中,EBV-DNA阳性组比EBV-DNA阴性组具有更高的皮疹、关节炎和血液系统异常发生率以及更高的抗Rib-P抗体、抗Smith抗体、高免疫球蛋白血症阳性率(P<0.05),但两者在系统性红斑狼疮疾病活动指数(SLEDAI)评分方面差异无统计学意义(P>0.05);SLE患者中,EBV-DNA阳性组血清IL-4浓度和外周血Th2细胞数显著高于EBV-DNA阴性组和对照组(P<0.01和P<0.05),Th1/Th2比值低于EBV-DNA阴性组和对照组(P<0.05)。结论:EBV感染与SLE密切相关,EBV可能通过促进Th2型免疫反应来促进SLE的发病。Objective： To the correlation between EBV infection and SLE the effect explore and of EBV infection on Thl/Th2 balance in SLE patients. Methods： Blood samples of 90 SLE patients and 70 health control cases were collected. An assay for EBV DNA specific segment in peripheral blood lymphocytes detected the positive rate of EBV infection. Serum levels of IFN-y and IL-4 were assayed using the mouse cytokines ELISA Kit. The rates of the CD3＋ （T） ceils, CD3＋CD4＋ （Th） ceils and the CD3＋CD4＋IFN-γ＋IL-4- （Thl） cells, CD3＋CD4＋IL-4＋IFN-γ- （Th2） cells were detected using single-cell measurement of intracellular cytokines by flow cytometry. Results： Much higher rate of EBV infection was detected in lupus patients than matched controls （P〈0.01）. EBV-DNA positive SLE patients showed higher incidence of rashes, arthritis, hematologic disorders, autoantibodies such as anti-Smith antibody, anti-Rib-P antibody （P〈0.05）, but there was no significant difference between the EBV-DNA positive and negative SLE patients. The serum level of IL-4 and Th2 cell counts were much higher in EBV-DNA positive SLE patients than that in the negative group. Conclusion： EBV infection is closely related to SLE, and it may aggravated the onset of SLE through the promotion of Th2 type immunoreaction.

关 键 词：红斑狼疮 系统性 EB病毒 TH1细胞 TH2细胞 

分 类 号：R593.24[医药卫生—内科学]