系统性红斑狼疮患者P-糖蛋白与淋巴细胞亚群的相关性研究  

Association between P-glycoprotein and lymphocyte subsets in systemic lupus erythematosus

作　　者：穆艳飞 王彩虹[1] 罗静[1] 赵文鹏[1] 赵向聪[1] 李小峰[1] 

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中国药物与临床》2014年第5期572-575,共4页Chinese Remedies & Clinics

基　　金：山西省科技攻关项目(20110313013-1);山西省卫生厅科技项目(201201072)

摘　　要：目的探讨多药耐药蛋白P-糖蛋白(P-gp)的表达水平与淋巴细胞亚群计数在系统性红斑狼疮(SLE)患者中的关系及在预测疾病耐药性方面可能的机制。方法选择初发SLE患者20例和健康对照组15名。通过流式细胞术测定外周血淋巴细胞P-gp的表达水平和淋巴细胞亚群的计数。分析SLE患者外周血淋巴细胞P-gp的表达水平与淋巴细胞亚群中CD4+T细胞,CD8+T细胞、自然杀伤细胞、总T细胞和总B细胞等的相关性。采用t检验和χ2检验、Pearson相关性分析进行统计学分析。结果①健康对照组与SLE患者外周血淋巴细胞的相对荧光强度(RFI)平均值分别为2.2±0.7、3.3±2.0,差异有统计学意义(t=18.8,P<0.01)。②SLE患者外周血淋巴细胞P-gp的表达与淋巴细胞亚群中总T细胞,总B细胞,NK细胞的计数均无相关性,但P-gp的表达水平与CD4+T细胞、CD4+/CD8+比值有相关性(r=0.602,P=0.002;r=0.561,P=0.005)。③根据SLE患者外周血淋巴细胞亚群计数分为增高组和降低组,分别与相应的RFI值比较,发现CD4+T细胞及CD4+/CD8+比值的增高组与相应P-gp的表达呈正相关(r=0.713,P=0.025;r=0.628,P=0.014)。结论外周血淋巴细胞的P-gp表达是SLE患者多药耐药性的指标,SLE患者药物跨膜转运蛋白P-gp表达水平尚与其存在免疫功能异常亢进淋巴细胞亚群中CD4+T细胞及CD4+/CD8+比值密切联系,提示P-gp可能是药物治疗疗效的指标,对改善预后和联合治疗减少耐药有重要的意义。Objective To study the expression of multi-drug resistance protein P-glycoprotein （P-gp） and lym-phocyte subset count in patients with systemic lupus erythematosus （SLE）, and to explore the possible mechanisms in predicting drug resistance. Methods Twenty patients with treatment-naive SLE and 15 healthy controls were en-rolled. The expression of peripheral blood lymphocytes P-gp and the lymphocyte subset count were detected by flow cytometry. This entailed analysis on the association of P-glycoprotein and lymphocyte subsets, including CD4＋T cell or helper T cells （Th）, CD8＋T cells, natural killer cells （NK）, total T lymphocytes and B lymphocytes in patients with SLE. Statistical analyses, including t-test for independent samples, χ2 test for quantitative data and Pearson′s correla-tion analysis, were conducted by using SPSS 17.0. Results Mean relative fluorescence intensity （RFI） of P-gp was significantly higher in patients with SLE [（3.3＆#177;2.0） vs （2.2＆#177;0.7）, t=18.8, P〈0.01]. There was no correlation between the expression of P-gp and total T, B and NK cells in SLE patients （all P〉0.05）, but P-gp expression was significantly correlated with CD4＋T cells and the ratio of CD4＋/CD8＋cells （r=0.602, P=0.002; r=0.561, P=0.005）. In patients with increased CD4＋T cells and the ratio of CD4＋/CD8＋cells, the P-gp was positively correlated with RFI （r=0.713, P=0.025; r=0.628, P=0.014）. There was no correlation between the expression of P-gp and sex and the age of onset in patients with SLE. Conclusion The expression of peripheral blood lymphocytes P-gp is an index reflecting multi-drug resistance in SLE. The expression of P-gp is significant correlated with the number of CD4＋T cells and the ratio of CD4＋/CD8＋cells in the abnormal lymphocyte subsets, suggesting that P-gp may be an indicator of the efficacy of drug treatment, and may play an important role to improve prognosis and reduce the drug resistance in SLE.

关 键 词：红斑狼疮 系统性 P糖蛋白 淋巴细胞亚群 

分 类 号：R593.241[医药卫生—内科学]