胸腺瘤并发重症肌无力患者免疫调节因子的表达  

The expression of immune regulatory factors in thymoma with myasthenia gravis

作　　者：张晖[1] 张鹏[1] 刘毅梅[1] 陈渊[1] 李新[1] 吕朋[1] 王元国[1] 

机构地区：[1]天津医科大学附属总医院心胸外科,300052

出　　处：《中华胸心血管外科杂志》2017年第3期155-159,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：天津市应用基础与前沿技术研究计划重点项目（14JCZDJC57100）

摘　　要：目的 探讨胸腺瘤合并重症肌无力（myasthenia gravis,MG）患者肿瘤组织及血液中Aire、Foxp3、AchR及血液相关免疫学因子的表达及其在胸腺瘤伴发MG发病中的重要意义.方法 分别采用RT-PCR及SP免疫组化方法检测胸腺瘤伴发MG胸腺瘤组织中Aire、Foxp3、AchR mRNA及蛋白的表达,比较外周血T细胞亚群及免疫球蛋白等免疫学指标并结合临床特征进行统计学分析.结果 Aire、Foxp3、AchR mRNA及蛋白在合并重症肌无力患者胸腺瘤组织中表达降低,在Ossermann分型、病理类型、Masaoka分期之间差别有统计学意义（P＜0.05）,CD4^ ＋/CD8^＋T细胞比值在胸腺瘤合并重症肌无力患者血清中增高（P＜0.05）.结论 Aire、Foxp3、AchR的异常表达在胸腺瘤伴发MG中发挥重要作用,CD4 ^＋/CD8^＋T细胞比值、免疫球蛋白和补体C3的水平可作为评价胸腺瘤患者免疫状态的关键指标,具有重要的临床意义.Objective To investigate the expression of Aire,Foxp3,AchR and other immune factors in human thymoma tissue and plasma and explore their role in myasthenia gravis with thymoma.Methods T lymphocyte subsets,immunoglobulin and other immune factors in plasma were compared,and the Expression of Aire,Foxp3 and AchR were examined in thymoma by reverse transcriptional polymerase chain reaction and immunohistochemical staining,and the results were analyzed by SPSS statistics software.Results The ratio of CD4 ^＋ to CD8^ ＋ T lymphocyte was much higher in plasma,while the expressions of Aire,Foxp3 and AchR at mRNA and protein level were much lower in thymoma patients with myasthenia gravis,and related to Ossermann subtype,WHO subgroup and Masaoka stage.The differences were statistically significant （P 〈 0.05）.Conclusion The ratio of CD4 ^＋ to CD8 ^＋ T lymphocyte and the abnormal expressions of Aire and Foxp3could used as an indicator of immune state in thymoma patient with myasthenia gravis and play an important role in the development of thymoma with myasthenia gravis,but the mechanism is indefinite.

关 键 词：胸腺瘤 重症肌无力 自身免疫性疾病 自身免疫调节因子 叉头状转录因子 乙酰胆碱受体 

分 类 号：R746.1[医药卫生—神经病学与精神病学] R736.3[医药卫生—临床医学]