激素对系统性红斑狼疮患者外周血滤泡辅助性T细胞及其亚群组成的影响  

Effects of steroids on circulating follicular helper T cell-like CD4^＋ T cells in patients with systemic lupus erythematosus

作　　者：徐淑琴 包韦乔 吴蓓颖[1] 杨帆[1] 王剑飚[1] 林琳[1] 蔡刚[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院检验科,200025

出　　处：《中华微生物学和免疫学杂志》2017年第11期816-821,共6页Chinese Journal of Microbiology and Immunology

摘　　要：目的 本研究拟对系统性红斑狼疮（systemic lupus erythematosus, SLE）患者外周血滤泡辅助性T细胞（follicular helper T cell, Tfh）及其亚群进行分析，探讨其与疾病状态的关系，并评价激素治疗是否能对Tfh细胞及其亚群分布产生影响。方法 本研究共纳入27例SLE患者（10例非活动性患者、17例活动性患者）和21例性别年龄匹配的健康对照者，用流式细胞术检测其外周血Tfh细胞及其亚群，分析外周血Tfh细胞及其亚群分布与疾病活动度和抗双链DNA抗体的关系。收集8例健康者外周血单个核细胞，在体外给予激素处理，检测激素处理组与阴性对照组外周血Tfh细胞及其亚群的分布情况。收集12例SLE患者，纳入的患者接受较高剂量的激素治疗（200-500 mg/d，2-3 d），检测纳入的患者激素治疗前后的外周血Tfh细胞及其亚群的分布情况。结果 SLE患者外周血Tfh比例与健康对照组没有明显差异（P〉0.05），但SLE患者Tfh17比例显著高于健康对照组（P〈0.05）。疾病活动组Tfh1比例显著低于疾病非活动组和健康对照组，差异具有统计学意义（P〈0.05），且Tfh1比例与SLE疾病活动指数（SLEDAI）评分呈负相关（r＝－0.44，P〈0.05）。抗双链DNA抗体阳性组Tfh2比例显著高于抗双链DNA抗体阴性组（P〈0.05）。健康者体外激素刺激试验显示，激素显著下调Tfh细胞（P〈0.01）、Tfh2细胞（P〈0.01）和Tfh1细胞（P〈0.05）的比例，增加Tfh17细胞的（P〈0.01）比例。SLE患者体内激素治疗试验显示，激素在下调外周血Tfh细胞（P〈0.01）、Tfh2细胞（P〈0.01）和Tfh1细胞（P〈0.05）比例的同时增加Tfh17（P〈0.01）比例。结论 外周血Tfh细胞亚群分布异常与SLE疾病的活动度和抗双链DNA抗体水平相关；激素治疗影响患者外周血Tfh细胞及其亚群分布。Objective To analyze changes in the percentages of circulating follicular helper T （Tfh） cells and Tfh subsets in patients with systemic lupus erythematosus （SLE） for better understanding their relationships with SLE, and to investigate effects of steroids on circulating Tin cells. Methods Pe- ripheral blood mononuclear cells （PBMCs） from 27 patients with SLE （including 10 inactive patients and 17 active patients） and 21 sex- and age-matched healthy donors were analyzed by flow cytometry to detect the percentage of CD4^＋CD45RA^-CXCR5^＋ Tfh-like ceils. Disease activity and the concentration of anti-double- stranded DNA （anti-dsDNA） antibody were evaluated by SLEDAI score （SLE disease activity index） and ELISA, respectively. PBMCs from healthy donors were treated with or without prednisone to evaluate its effects on circulating Tin ceils. Twelve patients with SLE were treated with high-dose steriods （200- 500 mg/d, 2-3 d） and the percentages of circulating Tfh cells and Tin subsets in them were analyzed before and after treatment. Results No significant difference in the percentage of circulating Tfh cells was ob- served between patients with SLE and healthy donors （ P〉0.05 ）, but the percentage of Tfhl7 cells in pa- tients with SLE was significantly higher than that in healthy donors （ P〈0.05 ）. Compared with patients with inactive SLE and healthy donors, patients with active SLE had a lower percentage of Trial cells （P〈0.05）.Moreover, the percentage of Tfhl cells was negatively correlated with SLEDAI score （r=-0.44, P〈0.05）. The percentage of Tfh2 ceils in anti-dsDNA antibody-positive group was significantly higher than that in anti- dsDNA antibody-negative group （P〈0.05）. In vitro treatment of PBMCs from healthy donors with predni- sone could significantly down-regulate the percentage of circulating Tfh （ P〈0.01 ）, Tfhl （ P〈0.05 ） and Tfh2 cells （P〈0.01）, and up-regulate the percentage of Tfhl7 ceils （P〈0.01）. In vivo treatment

关 键 词：系统性红斑狼疮 外周血滤泡辅助性T细胞 醋酸泼尼松 

分 类 号：R593.241[医药卫生—内科学]