1型糖尿病患者外周血滤泡调节性T细胞、调节性B细胞和调节性浆细胞的变化特点  

Change characteristics of follicular regulatory T cells,regulatory B cells and regulatory plasma cells in peripheral blood of patients with type 1 diabetes mellitus

作　　者：李蕾[1] 康志强[1] 刘红梅[1] 王欢欢[1] 高慧桢 李清楚[1] LI Lei;KANG Zhi-qiang;LIU Hong-mei;WANG Huan-huan;GAO Hui-zhen;LI Qing-chu(Endocrinology Department,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州市中心医院内分泌科,河南郑州450007

出　　处：《临床医学研究与实践》2020年第17期1-4,8,共5页Clinical Research and Practice

摘　　要：目的 探讨1型糖尿病患者外周血滤泡调节性T细胞(Tfr)、调节性B细胞(Breg)和调节性浆细胞(Preg)的变化特点.方法 将2018年6月至2019年10月来我院就诊的30例1型糖尿病初治患者分为治疗前组(给予胰岛素治疗前)和治疗后组(胰岛素治疗血糖控制达标后第7天),同时选取同时期的30名健康志愿者作为对照组.采用流式细胞术检测B细胞、Breg、滤泡辅助性T细胞(Tfh)、Tfr、浆细胞和Preg的比例;采用ELISA法检测外周血血清中白细胞介素-10(IL-10)和白细胞介素-21(IL-21)的浓度.结果 治疗前组的B细胞、Tfh和浆细胞比例均显著高于对照组,Breg和Tfr的比例显著低于对照组(P<0.05);治疗后组B细胞、Tfh和浆细胞的比例均低于治疗前组,Breg和Tfr的比例显著高于治疗前组(P<0.05);各组Preg的比例无显著差异(P>0.05).治疗前组的IL-21浓度显著高于对照组,IL-10浓度显著低于对照组(P<0.05);治疗后组的IL-21浓度显著低于治疗前组,IL-10浓度显著高于治疗前组(P<0.05).结论 1型糖尿病患者体内体液免疫处于激活状态,机体体液免疫抑制因素显著下降,治疗后复又升高,恢复至相对正常水平.Objective To investigate the change characteristics of follicular regulatory T cells(Tfr),regulatory B cells(Breg)and regulatory plasma cells(Preg)in peripheral blood of patients with type 1 diabetes mellitus.Methods From June 2018 to October 2019,30 newly treated patients with type 1 diabetes mellitus were divided into pre-treatment group(before given insulin treatment)and post-treatment group(on the 7th day after insulin therapy and blood glucose control up to standard).Meanwhile,30 healthy volunteers in the same period were selected as control group.Flow cytometry was used to detect the proportion of B cells,Breg,follicular helper T cells(Tfh),Tfr,plasma cells and Preg,and ELISA was used to detect the concentration of interleukin-10(IL-10)and interleukin-21(IL-21)in peripheral blood serum.Results The proportion of B cells,Tfh and plasma cells in the pre-treatment group were significantly higher than those in the control group,the proportion of Breg and Tfr were lower than those in the control group(P<0.05);the proportion of B cells,Tfh and plasma cells in the post-treatment group were lower than those in the pre-treatment group,the proportion of Breg and Tfr were significantly higher than those in the pre-treatment group(P<0.05);there were no significant differences in the proportion of Preg among the groups(P>0.05).The concentration of IL-21 in the pre-treatment group was significantly higher than that in the control group,and the concentration of IL-10 was significantly lower than that in the control group(P<0.05);the IL-21 concentration of the post-treatment group was significantly lower than that of the pre-treatment group,and the IL-10 concentration was significantly higher than that of the pre-treatment group(P<0.05).Conclusion The humoral immunity of patients with type 1 diabetes mellitus is in an activated state,and the humoral immune suppression factors of the body significantly decrease,and then rise again after treatment,returning to a relatively normal level.

关 键 词：1型糖尿病 免疫调控 调节性B细胞 滤泡调节性T细胞 

分 类 号：R58[医药卫生—内分泌]