辅助T细胞多巴胺受体(DR)表达对类风湿关节炎(RA)患者疾病活动度的影响  

The influence of dopamine receptor(DR)expressed in T helper cell subsets on the disease activity of rheumatoid arthritis(RA)patients

作　　者：魏蕾[1] 孙颖[1] 马莉莉[1] 纪宗斐[1] 张卓君[1] 戴晓敏[1] 吴万龙[1] 岳涛 朱琦 沈杰 姜林娣[1] 

机构地区：[1]复旦大学附属中山医院风湿免疫科,上海200032 [2]上海光华中西医结合医院类风关内科,上海200052

出　　处：《复旦学报（医学版）》2015年第2期143-150,共8页Fudan University Journal of Medical Sciences

基　　金：上海市科委基础研究重点项目(12JC1402500)~~

摘　　要：目的 检测类风湿关节炎（rheumatoid arthritis,RA）患者外周血辅助T淋巴细胞（T helper cells,Th cells）不同亚群细胞膜表面多巴胺受体（dopamine receptor,DR）水平,分析其与疾病活动度、实验室指标及功能状态之间的关系。方法 选取25位初诊或3个月内未接受DMARDs治疗的RA患者（DAS28〉3.2）,12位健康对照及13位同期年龄匹配的骨关节炎（osteoarthritis,OA）患者。采用流式细胞术检测患者外周血Th细胞亚群表面DR1~DR5的表达情况,分析Th细胞DR表达水平与人口学资料、实验室检查、功能状态及疾病活动度之间的相关性。结果 RA组Th2细胞百分比为1.28%（0.74%~2.68%）,较健康对照组（中位数0.18%,四分位数间距0.11%~0.31%,P〈0.001）及OA组（中位数0.48%,四分位数间距0.03%~1.47%,P=0.029）明显升高。RA组Th2细胞DR2表达水平为25.40%（四分位数间距3.79%~37.10%）,明显高于健康对照组（中位数3.74%,四分位数间距0.00%~12.98%,P=0.006）及OA组（中位数3.45%,四分位数间距0.00%~20.55%,P=0.040）。RA组Th2细胞DR4表达量也高于健康对照组和OA组（健康对照组vs.RA组,P=0.022;OA组vs.组,P=0.010）。Th2细胞与关节肿胀数（swollen joint count,SJC）和简化疾病活动指数（SDAI）呈正相关（分别为r=0.421,P=0.036;r=0.396,P=0.050）。Th1细胞DR5百分比分别为2.22%（四分位数间距0.57%~12.24%）与SJC及临床疾病活动指数（CDAI）呈正相关（分别为r=0.492,P=0.012;r=0.445,P=0.026）。Th2细胞DR1和DR3百分比分别为11.15%（四分位数间距2.93%~36.20%）、9.80%（1.62%~23.05%）,均与健康评估问卷（Health Assessment Questionnaire,HAQ）评分呈负相关（分别为r=-0.469,P=0.018;r=-0.464,P=0.019）。结论 RA患者Th2细胞多巴胺受体DR2和DR4明显升高,Th细胞DR水平与RA患者SJC、CDAI及HAQ存在相关性。Objective To detect the expressions of dopamine receptor D1-D5 among different T helper（Th）cells in patients with rheumatoid arthritis（RA）and to analyze the correlation between dopamine receptor（DR）and disease activity,laboratory tests and functional status. Methods Patients with RA（n=25）,or osteoarthritis（OA）（n=13）diagnosed according to the ACR criteria,as well as healthy donors（n=12）were recruited in this study.RA patients were all treatment naive or free of disease-modifying antirheumatic drugs（DMARDs）at least for 3 months.Flow cytometry was performed to detect the dopamine receptor D1-D5 in Th1,Th2 and Th17 cells in three groups.Correlation analyses were made between the demographics,clinical data,functional status,disease activity and dopamine receptor expressions on Th cell subsets. Results The percentage of Th2 cells in patients with RA was 1.28%（0.74%-2.68%）and significantly higher than that in healthy controls（median 0.18%,IQR：0.11%-0.31%,P〈0.001）and patients with OA（median 0.48%,IQR：0.03%-1.47%,P=0.029）.Meanwhile,the dopamine receptor DR2 expressed on Th2 cells in rheumatoid arthritis group（median 25.40%,IQR：3.79%-37.10%）were remarkably elevated than that in healthy donors（median 3.74%,IQR：0.00%-12.98%,P=0.006）and OA patients（median 3.45%,IQR：0.00%-20.55%,P=0.040）.Th2 cells also expressed higher level of DR4 in RA group than that in healthy controls and OA group（P=0.022 and P=0.010,respectively）.A positive correlation was found between Th2 cells percentage and swollen joint count（SJC）（r=0.421,P=0.036）as well as SDAI（r=0.396,P=0.050）.DR5 expressed on Th1 cells in RA group was 2.22%（IQR：0.57%-12.24%）and had positive correlations with SJC（r=0.492,P=0.012）and CDAI（r=0.445,P=0.026）.DR1 and DR3on Th2 cells were 11.15%（IQR：2.93%-36.20%）and 9.80%（IQR：1.62%-23.05%）,and all negatively related with Health Assessment Questionnaire（HAQ）（DR1：r=-0.469,P=0.018;DR3：r=-0.464,P=0.019）.Conclusions Dopam

关 键 词：类风湿关节炎(RA) 辅助T细胞 多巴胺受体 疾病活动度 

分 类 号：R593.2[医药卫生—内科学]