强直性脊柱炎患者外周血CD4^+CD25^high CD127^low、CD8^+CD28^-调节性T细胞水平变化及临床意义  

Changes and clinical significances of CD4^+CD25^high CD127^low and CD8^+CD28^-regulatory T cell levels in peripheral blood of patients with ankylosing spondylitis

作　　者：张宇 马莉 吴青青 沈雪 ZHANG Yu;MA Li;WU Qing-Qing;SHEN Xue(Clinical Laboratory Science of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学医学检验学院,贵阳550004 [2]贵州医科大学附属医院临床检验中心,贵阳550004

出　　处：《中国免疫学杂志》2020年第13期1625-1630,共6页Chinese Journal of Immunology

基　　金：贵州省科技厅社会发展攻关项目(黔科合LG字[2011]034号)资助。

摘　　要：目的:探讨CD4^+CD25^high CD127^low、CD8^+CD28^-调节性T细胞(Treg)在强直性脊柱炎(AS)患者外周血中的表达及临床意义。方法:选取2017年9月~2019年3月于我院初次就诊的AS患者77例(非活动期47例、活动期30例)及健康对照者59例。流式细胞术(FCM)检测外周血CD4^+CD25^high CD127^low、CD8^+CD28^-Treg比例,流式细胞微球芯片捕获技术(CBA)检测血清IL-2、IL-6、TNF-α、IFN-γ、IL-17A水平,分析Treg细胞与AS疾病活动度和临床炎症活动指标的相关性。结果:AS活动组CD4^+CD25^high CD127^low Treg细胞比例低于AS非活动组和正常对照组(P<0.05,P<0.01);AS活动组和非活动组CD8^+CD28^-Treg细胞比例较健康对照组显著降低(P<0.01)。AS活动组CD8^+CD28+Tc细胞比例和CD8^+CD28+/CD8^+CD28^-明显高于AS非活动组和健康对照组,且AS非活动组CD8^+CD28+/CD8^+CD28^-高于健康对照组(P<0.05)。与健康对照组相比,AS活动组和AS非活动组血清IL-6、TNF-α、IL-17A水平显著升高,且AS活动组血清IL-6、IL-17A水平显著高于AS非活动组(P<0.05);3组志愿者IL-2水平差异无统计学意义(P>0.05)。AS活动组血清IFN-γ水平显著高于AS非活动组和健康对照组(P<0.05,P<0.01),但AS非活动组与健康对照组差异无统计学意义(P>0.05)。AS患者CD4^+CD25^high CD127^low Treg细胞比例与BASDAI、ESR、Hs-CRP呈负相关(r=0.654、0.517、0.577,P<0.01)。CD8^+CD28+Tc细胞比例及CD8^+CD28+/CD8^+CD28^-与BASDAI呈正相关(r=0.276、0.246,P<0.05)。结论:降低AS患者外周血CD4^+CD25^high CD127^low和CD8^+CD28^-Treg细胞比例、提高炎症细胞因子水平可能在AS疾病发生发展中起重要作用。Objective:To explore expression of CD4^+CD25^high CD127^low and CD8^+CD28^-regulatory T cells(Treg)and their clinical significances in peripheral blood of patients with ankylosing spondylitis(AS).Methods:77 frist-time consultancy AS patients(47 inactive and 30 active)and 59 healthy controls were selected from September 2017 to March 2019.Percentage of CD4^+CD25^high CD127^low Treg cells and CD8^+CD28^-Treg cells were examined by flow cytometry(FCM).Ctometric bead array(CBA)was used to measure serum IL-2,IL-6,TNF-α,IFN-γ,IL-17A levels.Relationships between Treg cells and AS disease activity indexes and other established clinical markers were evaluated.Results:Percentage of CD4^+CD25^high CD127^low Treg cells in active AS group were lower than those of inactive AS and healthy control groups(P<0.05,P<0.01).Percentage of CD8^+CD28^-Treg cells in active AS and inactive AS groups were lower than those of healthy control group(P<0.01).Percentage of CD8^+CD28+Tc cells and ratio of CD8^+CD28+/CD8^+CD28^-in active AS group were significantly higher than those in inactive AS and healthy control groups,and ratio of CD8^+CD28+/CD8^+CD28^-in inactive AS group were lower than those in healthy control group(P<0.05).Compared to healthy control,serum levels of IL-6,TNF-α,IL-17A in active AS and inactive AS grous were significantly higher,and even levels of IL-6,IL-17A were markedly higher in active AS group compared with inactive AS group(P<0.05).Level of IL-2 had no significant difference in three groups(P>0.05).Compared to active AS group,level of IFN-γwas significantly lower in inactive AS and healthy control groups(P<0.05,P<0.01),but had no significant difference between these two groups(P>0.05).Percentage of CD4^+CD25^high CD127^low Treg cells had negative correlation with BASDAI score,ESR,Hs-CRP(r=-0.654,-0.517,-0.577,P<0.01),while percentage of CD8^+CD28+Treg cells and ratio of CD8^+CD28+/CD8^+CD28^-cells had positive correlation with BASDAI score in AS patients(r=0.276,0.246,P<0.05).Conclusion:Decreasing of CD4^+CD25^h

关 键 词：强直性脊柱炎 调节性T细胞 细胞因子 活动度 

分 类 号：R593.23[医药卫生—内科学]