活动期系统性红斑狼疮患者调节性T细胞数量变化的Meta分析  

Meta analysis of the changes of regulatory T cell number in patients with active systemic lupus erythematosus

作　　者：项勇刚[1,2] 夏凌云[3] 曾宪涛[4] 张勇[2] 刘胜武[1] 

机构地区：[1]武汉大学医学院基础医学院免疫学教研室,湖北武汉430071 [2]湖北医药学院附属太和医院眼科 [3]湖北医药学院附属太和医院口腔科 [4]湖北医药学院附属太和医院循证医学中心,湖北十堰442000

出　　处：《细胞与分子免疫学杂志》2014年第11期1184-1189,共6页Chinese Journal of Cellular and Molecular Immunology

基　　金：湖北省科技厅自然科学基金(2011CDB126)

摘　　要：目的采用Meta分析探讨活动期系统性红斑狼疮(SLE)患者调节性T细胞(Treg)的改变。方法计算机检索PubMed及中国生物医学文献数据库(CBM)中公开发表的中英文文献,检索时限均为从建库至2013年8月31日,对符合纳入标准的研究进行质量评价及数据提取后,采用Comprehensive-Meta Analysis(CMA)v2.2软件进行Meta分析。结果共纳入22个病例-对照研究,其中有12个研究报道了调节性T细胞(Treg)数量变化,12个研究报道了Treg占CD4+T细胞的比例变化。结果显示,活动期SLE患者较健康者外周血中,调节性Treg数量降低1.23%(WMD=-1.23%,95%CI=-1.87%^-0.59%),以Treg表面标志物的不同进行亚组分析,结果显示CD4+CD25+Treg数量减少1.56%(WMD=-1.56%,95%CI=-2.18%^-0.94%),CD4+CD25highTreg数量减少0.91%(WMD=-0.91%,95%CI=-1.52%^-0.29%);活动期SLE患者较健康者外周血中,Treg占CD4+T细胞的比例变化与对照组相比无统计学差异。敏感性分析显示结果稳健性好,未有发表偏倚。结论当前证据表明,SLE可能更主要的是Treg的数量减少所致,而不是T细胞中Treg比例异常所致的免疫功能的改变。Objective To evaluate the change of regulatory T cells（Tregs） in patients with active systemic lupus erythematosus（SLE） using meta-analysis. Methods The PubMed and China Biomedical Literature（ CBM） databases were searched for relevant studies up to August 31,2013. After quality assessment and data extraction for included studies,a meta-analysis was performed using the software of Comprehensive-Meta Analysis（ CMA） v2. 2. Results Finally 22 case-control studies were recruited,including 12 studies reporting the change of Treg number and 12 studies for the change of Treg∶CD4^＋T cell ratio. The quality of studies was moderate to high. It demonstrated that the Treg number in peripheral blood mononuclear cells（ PBMCs） of active SLE patients significantly decreased than ones in controls（ WMD =-1.23%,95%CI =-1.87% to-0.59%）.Then,subgroup analysis was performed based on the different surface markers of Tregs. It showed that the Treg number in PBMCs of active SLE patients decreased by 1. 56% for the CD4^＋CD25^＋Tregs（ WMD =- 1. 56%,95% CI =- 2. 18% to- 0. 94%）,and by 0. 91% for the CD4^＋CD25^high Tregs（ WMD =- 0. 91%,95% CI =- 1. 52% to- 0. 29%） compared with ones in controls. As for the ratio of Tregs to CD4^＋T cells,there was no significant difference between the SLE patients and the controls. Sensitivity analysis showed the results were robust,and the Funnel Plots showed there was no publication bias.Conclusion Based on the current evidences,the development of SLE may be due to the decrease of Treg number in PBMCs,not to the abnormal ratio of Tregs to CD4^＋T cells.

关 键 词：调节性T细胞 CD4+CD25+T细胞 CD4+CD25+Foxp3+调节性T细胞 系统性红斑狼疮 META分析 

分 类 号：R392.11[医药卫生—免疫学] R593.241[医药卫生—基础医学]