天疱疮患者外周血滤泡辅助性T细胞的表达及其与血清抗Dsg抗体滴度的相关性  

The Expression of Follicular Helper T Cells in Peripheral Blood of Pemphigus Patients and the Correlation between it and Anti-Dsg1/Dsg3 Autoantibody Titer

作　　者：元慧杰[1] 刘芝翠[1] 潘萌[1] 王颖[2] 朱海琴[3] 郑捷[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院皮肤科,上海200025 [2]上海交通大学医学院上海市免疫学研究所,上海200025 [3]上海交通大学医学院附属瑞金医院北院皮肤科,上海200025

出　　处：《中国皮肤性病学杂志》2015年第9期894-897,共4页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金面上项目(81171499;81472875);国家自然科学基金青年项目(81201230)

摘　　要：目的探讨天疱疮患者外周血滤泡辅助性T细胞(TFH)的表达及其与血清抗桥粒芯糖蛋白(Dsg)1,3抗体滴度的相关性。方法收集寻常型天疱疮患者59例,红斑型54例,其中初发患者36例,稳定期患者51例,复发患者26例;健康对照25例。采用流式细胞术检测不同病期患者外周血CD4+T细胞及CD4+CD45RA-活化T细胞中的TFH的比例(CXCR5+PD-1+),和健康对照进行比较;分析部分患者治疗前后TFH的变化情况;并进一步对活化TFH和特异性抗Dsg1,Dsg3抗体滴度的相关性进行研究。结果初发、稳定期和复发的天疱疮患者外周血滤泡辅助性T细胞占CD4+T细胞及活化T细胞的比例均显著高于健康对照组(P<0.000 1)。治疗后患者的TFH明显下降,在活化T细胞中的比例下降更加明显。天疱疮患者外周血CD4+CD45RA-活化TFH与抗Dsg3抗体滴度呈微弱正相关(P=0.004)。结论天疱疮患者外周血TFH明显升高,与疾病的活动度有关,活化T细胞中TFH的比例变化更为敏感,可作为疾病活动度和疗效的评判指标。Objective To investigate the expression of follicular helper T cells （TFH） in PBMC of pemphigus patients, and the correlation with the anti-Dsgl and Dsg3 titer. Methods One hundred and thirteen pemphigus patients including acute stage 36, remission 51, relapsed stage 26, and 25 healthy human controls were enrolled in this study. Peripheral blood samples were obtained from these subjects followed by lymphocyte isolation. To detect the expression of CXCR5 and PD-1 on CD4 ＋ and CD4＋ CD45RA- T cells in peripheral blood of pem- phigus patients by flow cytometry, analyzing the difference of the proportion of TFH in patients of different stages and healthy human controls, and studying the variation of expression of TFH after patients treated to be quiescent. Meanwhile, we detected the anti-Dsgl and Dsg3 autoantibody titer by ELISA from the patients, further analyzed the correlation with TFH in peripheral blood. Results The expression of TFH in CD4 ＋ and CD4＋ CD45RA- T cells of pemphigus patients are remarkably higher than that in healthy controls （P 〈 0. 000 1 ）. After treated with glucocorticoid and acute pemphigus patients become remission,TFH in CD4 ＋ T cells of patients in acute stage declined. TFH from CD4＋ CD45RA- active T cells exhibited weak positive correlation with the titer of anti-Dsg3 autoantibody （ P = 0. 004）. Conclusion The expression of follicular helper T cells in peripheral blood of pemphigus patients has correlation with condition of illness and the production of specific pathogenic autoantibody.

关 键 词：天疱疮 滤泡辅助性T细胞 抗Dsg1抗体 抗Dsg3抗体 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]