多发性硬化患者外周血T淋巴细胞受体β链可变区多态性研究  

Polymorphism of the peripheral blood T cell receptorβchain variable region of T lymphocytes in patients with multiple sclerosis

作　　者：吴岩 张纪红 董会卿[1] 万岁桂[3] 孙雪静[3] 苏圣尧 WU Yan;ZHANG Jihong;DONG Huiqing;WAN Suigui;SUN Xuejing;SU Shengyao(Department of Neurology,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,100053 [2]南京医科大学附属脑科医院神经内科,210000 [3]首都医科大学宣武医院血液科,100053

出　　处：《中国神经免疫学和神经病学杂志》2018年第1期15-21,共7页Chinese Journal of Neuroimmunology and Neurology

基　　金：首都市民健康项目培育(Z131100006813020)

摘　　要：目的探讨多发性硬化(MS)不同阶段外周血T淋巴细胞受体β链可变区(TCRVβ)多态性的特点。方法收集首都医科大学宣武医院神经内科临床孤立综合征(CIS)患者30例、复发-缓解型多发性硬化(RRMS)患者40例、继发-进展型多发性硬化(SPMS)患者10例、健康对照者30名,经TCRVβ单克隆抗体标记后采用流式细胞仪分析各组外周血TCRVβ扩增程度以及TCRVβ24个亚家族扩增患者百分比、扩增片段所占百分比的差异。结果 CIS、RRMS及SPMS组TCRVβ存在扩增患者比例、扩增个数和扩增分数均高于对照组(P<0.01),而CIS、RRMS及SPMS组间比较无统计学差异(P>0.05)。CIS、RRMS及SPMS组CD4+TCRVβ2扩增频率均高于对照组(P<0.008),CIS组、RRMS及SPMS组CD8+TCRVβ11表达水平均低于对照组(P<0.05),SPMS组CD4+TCRVβ21.3表达水平低于CIS组(P<0.05)。ROC曲线分析提示CD8+TCRVβ11的扩增片段所占百分比对MS诊断具有一定价值,对MS分型无诊断价值;CD4+TCRVβ21.3的扩增片段所占百分比对SPMS诊断具有一定价值。结论可通过检测部分TCRVβ片段对MS及SPMS的早期诊断提供相关依据。Objective To investigate the diagnostic value of T cell receptorβchain variable region(TCRVβ)in peripheral blood of clinically isolated syndrome(CIS),relapsing-remitting multiple sclerosis(RRMS)and secondary-progressive multiple sclerosis(SPMS)patients.Methods Hospitalized patients of Xuanwu Hospital form 2012.08.20 to 2014.03.20,who met the inclusion and exclusion criteria,were divided into 4 groups.Three experimental groups:CIS group of 30 patients,RRMS group of 40 patients,SPMS patients of 10 cases,and the control group:30 healthy volunteers.Sex and age were well matched.We took 2 mL EDTA anticoagulated peripheral blood from the subjects,then analyzed the polymorphism of TCRVβby flow cytometry.We got the statistic of qualitative and quantitative expression of TCRVβ(total of 24 subfamilies).The usage of TCRVβcan be descripted by the number of the clonal expanded TCRVβfragments(expression≥10%of all TCRVβ)and expansion fraction(the accumulation of expansion degree).Results TCRVβwas significantly higher in the disease groups than the control group(P<0.01),there were no significant difference between disease groups(P>0.05).Quantitative and qualitative analysis of TCRVβ:CD4+TCRVβ2 was significantly expanded in diseases groups;CD8+TCRVβ11 was significantly reduced in disease groups,CD4+TCRVβ21.3 of the CIS group was significantly decreased than the SPMS group.Receiver operating characteristic(ROC)curve analysis indicated that CD8+TCRVβ11 fragments had some diagnostic value for MS,and CD4+TCRVβ21.3 fragments had some diagnostic value for SPMS.Conclusions The early diagnosis of MS and SPMS can be partly facilitated by detecting some TCRVβfragments.

关 键 词：基因重排 β链T细胞抗原受体 多发性硬化 多发性硬化 复发缓解型 多发性硬化 继发进展型 临床孤立综合征 多态性 单核苷酸 

分 类 号：R744.51[医药卫生—神经病学与精神病学]