Tfh通过CD40／CD40L轴在介导儿童过敏性紫癜发病中的作用与机制初探  

Follicular helper T （Tfh） cells involves in the pathogenesis of Henoch-Schonlein purpura through affecting CD40/CD40L axis

作　　者：李婷[1] 唐筱潇 阳海平[2] 王墨[2] 张高福[2] 陈学兰[2] 黎小芹[2] 李秋[2] Li Ting, Tang Xiaoxiao, Yang Haiping, Wang Mo, Zhang Gaofu, Chen Xuelan, Li Xiaoqin, Li Qiu(Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China ; Department of Nephrology, Children＇s Hospital of Chongqing Medical University, Chongqing 400014, China)

机构地区：[1]儿童发育疾病研究教育部重点实验室、儿科学重庆市重点实验室、儿童发育重大疾病国家国际科技合作基地,重庆400014 [2]重庆医科大学附属儿童医院肾内科,400014

出　　处：《中华微生物学和免疫学杂志》2018年第1期47-54,共8页Chinese Journal of Microbiology and Immunology

基　　金：国家自然科学基金（81470946,81770713）

摘　　要：目的探讨滤泡辅助性T细胞（Tfh）通过CD40/CD40L轴参与过敏性紫癜（HSP）及紫癜性肾炎（HSPN）发生发展的免疫学机制。方法选取急性期初发HSP患儿和健康体检儿童共55例，HSP患儿根据肾脏累及情况分3组：无肾脏累及组22例（A组）、纯血尿组11例（B组）、血尿合并蛋白尿组11例（C组）；另设正常对照组11例。用流式细胞术检测外周血CD19＋B细胞及亚类比例，分泌不同Ig的CD19＋B、CD19＋CD38＋B细胞比例，及CD19＋B细胞及亚类上CD40和Tfh上CD40L表达水平。结果与对照组相比，C组中CD19＋CD86＋B、CD19＋CD138＋B细胞、CD40L＋Tfh比例增加，差异有统计学意义（P〈0.05），A、B组中上述指标有增加趋势，但差异无统计学意义（P〉0.05）。与对照组相比，A、B、C组中CD19＋B、CD19＋CD27＋B细胞、表达CD40的CD19＋B细胞及其亚类、分泌IgG和IgM及IgD的CD19＋B、CD19＋CD38＋B细胞比例差异无统计学意义（P〉0.05），而A、B、C组中分泌IgA和IgE的CD19＋B、CD19＋CD38＋B细胞比例增加，差异有统计学意义（P〈0.05）。分泌IgA的CD19＋B、CD19＋CD38＋B细胞与CD40L＋Tfh呈显著正相关（P〈0.05）。结论Tfh介导CD40/CD40L信号通路异常可能是影响HSP发生及HSPN肾脏损害严重程度的免疫学机制。ObjectiveTo investigate whether follicular helper T （Tfh） cells were involved in the development of Henoch-Sch？nlein purpura （HSP） and Henoch-Sch？nlein purpura nephritis （HSPN） in children through affecting CD40/CD40L axis.MethodsFifty-five subjects were enrolled in this study and divided into four groups as follows： 22 children with HSP but without renal involvement （Group A）, 11 children with HSPN presenting with microhematuria （Group B）, 11 children with HSPN presenting with microhematuria and proteinuria （Group C） and 11 healthy children （control group）. Flow cytometry was performed to detect the percentages of CD19＋ B cells and their subsets, CD19＋ B cells and CD19＋ CD38＋ B cells secreting different Ig classes, CD19＋ CD40＋ B cells and their subsets and Tfh cells expressing CD40 ligand （CD40L）.ResultsCompared with the control group, the percentages of CD19＋ CD86＋ B, CD19＋ CD138＋ B and CD40L＋ Tfh cells significantly increased in Group C （P〈0.05） and slightly increased in Groups A and B （P〉0.05）. No significant difference in the percentages of CD19＋ B cells, CD19＋ CD27＋ B cells, CD19＋ B cells or CD19＋ CD38＋ B cells expressing IgG, IgM, IgD, CD19＋ B cells or CD19＋ B cell subsets secreting CD40 was found between the control group and Groups A, B and C （P〉0.05）. Moreover, the percentages of CD19＋ B and CD19＋ CD38＋ B cells secreting IgA and IgE in Groups A, B and C were higher than those in the control group （P〈0.05）. Secretion of IgA by CD19＋ B and CD19＋ CD38＋ B cells were positively correlated with the expression of CD40L by Tfh cells （P〈0.05）.ConclusionTfh cell-mediated abnormal expression of CD40/CD40L might play an important role in the development of HSP and be related to the clinical severity of renal involvement in HSPN.

关 键 词：过敏性紫癜 免疫球蛋白 B细胞 滤泡辅助性T细胞 CD40/CIM0配体 

分 类 号：R725.5[医药卫生—儿科]