类风湿关节炎单核巨噬细胞极化表型分析及临床意义  

Analysis of monocytes-macrophage polarization phenotype in patients with rheumatoid arthritis and its clinical significance

作　　者：黄自坤[1] 李雪[2] 罗清[1] Huang Zikun;Li Xue;Luo Qing(Dept of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang 330006;Medical College of Nanchang University, Nanchang 330006)

机构地区：[1]南昌大学第一附属医院检验科,南昌330006 [2]南昌大学医学院,南昌330006

出　　处：《安徽医科大学学报》2018年第4期605-609,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81360459);江西省青年科学基金(编号:20151BAB215031);江西省卫生计生委科技计划课题(编号:20165094);江西省自然科学基金(编号:20171BAB205113)

摘　　要：目的探讨类风湿关节炎(RA)患者和骨关节炎(OA)患者的单核巨噬细胞极化表型以及临床意义,以阐明其在RA和OA发生和发展中的作用。方法应用流式细胞仪检测28例RA患者和20例OA外周血单核细胞表面以及28例RA患者和6例OA患者关节腔积液巨噬细胞表面极化指标表达水平,比较RA组和OA组之间单核细胞表面以及RA组和OA组之间巨噬细胞表面极化指标表达水平,并分析RA患者关节腔积液巨噬细胞表面极化指标与实验室检查数据的相关性。两组间比较采用t检验或者非参数检验,两变量之间相关性采用Pearson或Spearman相关分析。结果 (1)RA组外周血单核细胞CD163、CD206、CD40、CD64和HLA-DR表达的平均荧光强度(MFI)显著高于OA组(P<0.05)。(2)RA组关节腔积液巨噬细胞CD206、CD40、CD86和HLA-DR表达的MFI显著高于RA组外周血单核细胞(P<0.05);RA组关节腔积液巨噬细胞CD206、CD40和CD64表达百分率显著高于外周血(P<0.05);RA患者组关节腔积液巨噬细胞CD163表达百分率低于外周血单核细胞(P<0.05)。(3)RA组关节腔积液巨噬细胞HLA-DR表达百分率显著高于OA组(P<0.05);RA组关节腔积液巨噬细胞CD163表达百分率低于OA组(P<0.05)。(4)RA患者关节腔积液巨噬细胞上CD163表达百分率与ACPA的含量呈正相关性(rs=0.428,P=0.042)。结论 RA患者外周血单核细胞极化指标表达异常,呈现M1和M2混合型;RA患者关节腔积液巨噬细胞极化指标表达异常,呈现为M1型,并且与自身抗体抗环瓜氨酸多肽抗体相关。Objective To investigate the polarization phenotype of monocytes/macrophages from patients with rheumatoid arthritis（ RA）,osteoarthritis（ OA） and its significance and to clarify its role in the development of RA,OA. Methods The peripheral blood mononuclear cell（ PBMC） from 28 RA patients and 20 OA were collected and polarization phenotype expression in the monocytes were detected by flow cytometry. The mononuclear cell in synovial fluid from 28 RA patients and 6 OA patients were collected and polarization phenotype expression in the macrophages were detected by flow cytometry. The expression level of polarization phenotype on monocytes in peripheral blood and the expression level of polarization phenotype on macrophages in synovial fluid were compared between RA patients and OA patients. The correlations of polarization phenotype on macrophages in synovial fluid with laboratory index were analyzed. A t-test or the nonparametric Mann-Whitney test was used to analyze the data.The Pearson method or the nonparametric Spearman method was used for correlation analysis. Results（1） The mean fluorescence intensity（ MFI） of CD163,CD206,CD40,CD64 and HLA-DR on peripheral monocytes were significantly elevated in RA patients compared to OA patients（ P〈0. 05）.（2） The MFI of CD206,CD40,CD86 and HLA-DR on macrophages in synovial fluid were significantly elevated in RA patients compared to peripheral monocytes（ P 〈0. 05）. The percentage of CD206＋,CD40＋and CD64＋macrophages in synovial fluid were significantly elevated in RA patients compared to peripheral monocytes（ P〈 0. 05）. The percentage of CD163＋macrophages in synovial fluid were significantly decreased in RA patients compared to peripheral monocytes（ P 〈0. 05）.（3） The percentage of HLA-DR＋macrophages in synovial fluid were significantly elevated in RA patients compared to OA patients（ P 〈0. 05）. The percentage of CD163＋macrophages in synovial fluid were significantly decreased in RA patients compared to OA

关 键 词：类风湿关节炎 单核巨噬细胞 极化 

分 类 号：R593.22[医药卫生—内科学]