调节性B细胞在类风湿关节炎中的表达  

The expression of regulatory B cells in rheumatoid arthritis

作　　者：吴桂英[1] 李鸿斌[1] Wu Guiying;Li Hongbin(Department of Rheumatology and Immunology,Inner Mongolia Medical University Affiliated Hospital,Hohhot 010059,China)

机构地区：[1]内蒙古医科大学附属医院风湿免疫科,呼和浩特010059

出　　处：《国际免疫学杂志》2019年第1期45-51,共7页International Journal of Immunology

摘　　要：目的探讨调节性B细胞(regulatory B cells,Breg)及其相关细胞因子在类风湿关节炎(rheumatoid arthritis,RA)治疗前后表达率。方法选取2016年10月至2016年12月期间就诊于内蒙古医科大学附属医院风湿免疫科初诊的RA患者36例,另选取30名年龄性别相匹配的健康志愿者作为对照组。采用流式细胞术检测外周血单个核细胞中CD19+CD24hiCD38hi Breg细胞。酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测Breg细胞相关细胞因子。分别观察并记录基线期及第2、4、12 W临床表现、实验室检查及影像学检查结果,分析Breg细胞及相关细胞因子与其相关性。结果基线期RA患者CD19+CD24hiCD38hi Breg细胞及其细胞因子白细胞介素(interleukin,IL)-10和转化生长因子β(transforming growth factor-β,TGF-β)表达明显低于正常对照组(t=-17.38,P<0.05)。随着治疗时间的延长,RA患者关节压痛、肿胀等临床症状、实验室检查及影像学指标均改善,RA患者CD19+CD24hiCD38hi Breg表达率逐渐增多。治疗后RA患者CD19+CD24hiCD38hiBreg的表达率与RA的活动度呈负相关:用药2 W后与28项关节疾病活动评分(Disease Activity Score in 28 Joints,DAS28)、简化的疾病活动指数(Simple Disease Activity Index,SDAI)呈负相关(r值分别为-0.69,-0.48;P<0.05);用药4 W后与临床疾病活动指数(Clinical Disease Activity Index,CDAI)、SDAI呈负相关(r值分别为-0.58,-0.76;P<0.05);用药12 W后与DAS28、CDAI呈负相关(r值分别为-0.90,-0.67;P<0.05)。结论基线期,RA患者外周血中CD19+CD24hiCD38hi Breg细胞及其相关细胞因子的表达水平均明显低于健康人。随着治疗时间的延长,RA患者的CD19+CD24hiCD38hiBreg表达率逐渐增多,且CD19+CD24hiCD38hiBreg表达率与病情活动性评分呈负相关,推测CD19+CD24hiCD38hiBreg细胞负向调控作用的缺失可能参与了RA发病机制。Objective To investigate the correlation between regulatory B cells (Breg) and its related cytokines before and after treatment of rheumatoid arthritis (RA). Method Total of 36 newly diagnosed RA patients who visited department of Rheumatology in Inner Mongolia Medical Affiliated Hospital from October 2016 to December 2016 were entrolled in the study.Thirty age-and gender-matched healthy volunteers were entrolled as the control group.Peripheral blood CD19+CD24hiCD38hi phenotype B cells percentage were tested by flow cytometry.Enzyme-linked immunosorbent assay (ELISA) was used to test interleukin(IL)-10 and transforming growth factor -β(TGF-β).Clinical manifestation,laboratory examination results and imaging index were collectd at the baseline,2,4,12 W.The correlation between Breg cells,related cytokines and the upper datas were analyzed. Results CD19+CD24hiCD38hi Breg cells percentage,TGF-β and IL-10 was significantly lower than the control group at baseline(t=-17.38,P<0.05).After treatment,tenderness joint count,swelling joint count,laboratory tests and imaging examination were improved.CD19+CD24hiCD38hi Breg cells percentage was gradually increased.In addition,CD19+CD24hiCD38hi Breg cells percentage was negatively correlated with the Disease Activity Scores in 28 Joints(DAS28) and Simple Disease Activity Index(SDAI)(2 W: r values were-0.69 and -0.48 respectively;both P<0.05);and negatively correlated with the Clinical Disease Activity Index(CDAI) and SDAI(4 W: r values were -0.58 and -0.76 respectively;both P<0.05);and also negatively correlated with the DAS28 and CDAI(12 W: r values were -0.90 and -0.67 respectively;both P<0.05). Conclusion The expression level of CD19+CD24hiCD38hi Breg cells and related cytokines in RA patients were significantly lower than the healthy controls at the baseline.With the prolongation of treatment,the expression rate of CD19+CD24hiCD38hi Breg cells was gradually increased,which negatively correlated with disease activity scores.It suggested that the deficiency of Breg cells m

关 键 词：调节性B细胞 类风湿关节炎 白细胞介素-10 转化生长因子Β 

分 类 号：R593.22[医药卫生—内科学]