不同免疫细胞亚群引起的炎症参与类风湿性关节炎骨破坏  

Inflammation caused by different immune cell subsets is involved in bone destruction of rheumatoid arthritis

作　　者：万磊[1] 刘健[1] 黄传兵[1] 谌曦[1] 赵磊 范海霞[1] 葛瑶[1] 刘天阳[1] 刘磊[1] WAN Lei;LIU Jian;HUANG Chuanbing;CHEN Xi;ZHAO Lei;FAN Haixia;GE Yao;LIU Tianyang;LIU Lei(Department of Rheumatology,First Affiliated Hospital,Anhui University of Chinese Medicine,Hefei 230031,China;School of Graduate,Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院风湿病科,安徽合肥230031 [2]安徽中医药大学研究生院,安徽合肥230031

出　　处：《细胞与分子免疫学杂志》2020年第11期1026-1031,共6页Chinese Journal of Cellular and Molecular Immunology

基　　金：科技部国家重点研发计划中医药现代化研究重点专项(2018YFC1705204);国家自然科学基金(81973655);安徽省重点研究和开发计划对外科技合作项目(201904b11020011);安徽省省级质量工程教学研究项目(2018jyxm1068);安徽省名中医刘健工作室建设项目(中医药发展秘[2018]11号);全国中医药创新骨干人才培训项目(国中医药人教函[2019]128号);安徽省重点研究与开发计划项目(201904a07020004);安徽现代中医内科应用基础与开发研究省级实验室项目(2016080503B041);安徽省第12批“115”创新团队项目(皖人才办[2019]1号);安徽省教育厅高校自然科学研究重点项目(KJ2018A0279)。

摘　　要：目的观察类风湿性关节炎(RA)患者骨破坏与T细胞、调节性T细胞(Treg)、CD19^+B细胞及免疫炎症的关系。方法随机选取20例RA患者及20例正常对照者,采用DXEA双能X线骨密度仪测定骨密度,ELISA检测血清1型辅助T(Th1)细胞因子γ干扰素(IFN-γ)、Th2细胞因子白细胞介素4(IL-4)、IL-17、Ⅰ型前胶原蛋白氨基端前肽(PINP)、Ⅰ型胶原蛋白羧基端肽(CTx)、核因子κB受体激活蛋白配体(RANKL)、骨保护素(OPG)。采用流式细胞术测定外周血T细胞亚群、Treg、CD19^+B细胞,Spearman法分析T细胞、Treg、B细胞与骨密度、Th1、Th2细胞因子相关性。结果RA患者骨密度T值较正常对照组降低,在RA组中双前臂骨密度T值较腰椎降低。与正常对照组相比,RA组血清IFN-γ、IL-17、Th1/Th2细胞、CTx、RANKL升高,IL-4、PINP降低;RA组外周血CD4^+/CD8^+T细胞比值、CD19^+B细胞增加,CD8^+T细胞、CD4^+CD25^+Treg比例减少。相关性分析显示,RA外周血CD8^+T细胞与Th1/Th2细胞、IL-17呈正相关,CD4^+CD25^+Treg与CTx呈负相关,CD19^+B细胞与OPG呈负相关。结论T细胞、CD19^+B细胞可能通过释放细胞因子介导炎症参与RA骨破坏过程。Objective To observe the relationship of rheumatoid arthritis(RA)bone destruction with T cells,regulatory T cells(Tregs),CD19^+B cells and immune inflammation.Methods The study enrolled randomly 20 RA patients(RA group)and 20 normal controls(NC group).Bone mineral density was measured by DXEA dual energy X-ray bone densitometer.The serum levels ofγ-interferon(IFN-γ)of Th1 cells,interleukin-4(IL-4)of Th2 cells,IL-17,typeⅠprocollagen amino terminal propeptide(PINP),typeⅠcollagen carboxy terminal peptide(CTx),receptor activator of NF-κB ligand(RANKL)and osteoprotectin(OPG)were detected by ELISA.T-cell subsets,Tregs,CD19^+B cells in peripheral blood were measured by flow cytometry.Spearman method was used to analyze the correlations of T cells,Treg and CD19^+B cells with bone density and Th1 and Th2 cytokines.Results The bone mineral density T value of the RA group was lower than that of the NC group.The bone mineral density T value of the double forearm was lower than that of the lumbar spine in the RA group.Compared with the NC group,the expression of IFN-γ,IL-17,Th1/Th2 cells,CTx,RANKL increased,and IL-4,PINP decreased in the RA group.Compared with the NC group,the expression of CD4^+/CD8^+T cells,CD19^+B cells increased,and CD8^+T cells,CD4^+CD25^+Tregs decreased in the RA group.Correlation analysis showed that CD8^+T cells were positively correlated with Th1/Th2 cells and IL-17,while CD4^+CD25^+Tregs were negatively correlated with CTx,and CD19^+B cells were negatively correlated with OPG in RA.Conclusion T cells and CD19^+B cells may participate in the process of bone destruction in RA by mediating inflammatory immunity.

关 键 词：类风湿性关节炎(RA) 骨破坏 T细胞亚群 CD19^+B细胞 调节性T细胞(Treg) 免疫细胞 炎症 

分 类 号：R593.22[医药卫生—内科学] R453.9[医药卫生—临床医学]