显微镜下多血管炎患者外周血髓样树突状细胞和调节性T细胞的表达及意义  

Expression and significance of myeloid dendritic cells and regulatory T cells in peripheral blood of patients with microscopic polyangiitis

作　　者：丁秋燕 汪伟[1] 罗昊军 李怡[1] 丁涵露[1] DING Qiu-yan;WANG Wei1;LUO Hao-jun;LI Yi;DING Han-lu(Department of Nephrology, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072, China;Department of Nephrology, Zigong Fourth People′s Hospital, Zigong 643000, China)

机构地区：[1]四川省医学科学院·四川省人民医院肾内科,四川成都610072 [2]四川省自贡市第四人民医院肾内科,四川自贡643000

出　　处：《实用医院临床杂志》2022年第1期11-15,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅应用基础项目(编号:2018JY0332)。

摘　　要：目的探讨显微镜下多血管炎(MPA)患者外周血髓样树突状细胞(mDC)、调节性T细胞(Treg)水平与伯明翰系统性血管炎活动评分(BVAS)、肾组织病理损伤之间的关系。方法选择27例活跃期MPA患者(MPA活跃组)和18例缓解期MPA患者(缓解组),并以性别、年龄相匹配的健康志愿者15例为对照组,采用流式细胞技术三色分析法测定三组人群外周血中mDC占淋巴细胞的百分比、Treg细胞占CD4+细胞的百分比,其中mDC以Lin1^(-)HLA-DR^(+)CD11c^(+)确定,Treg细胞以CD4^(+)CD25^(high)CD127^(low)Treg细胞确定,将进行了肾穿刺的24例MPA患者分为局灶性12例,新月体性5例,混合性7例。结果MPA活跃组外周血mDC占淋巴细胞的百分比及CD4^(+)CD25^(high)CD127^(low)Treg细胞占CD4+细胞的百分比均较缓解组和健康对照组下降(P<0.05),mDC、CD4^(+)CD25^(high)CD127^(low)Treg细胞占比均与BVAS评分负相关(P<0.05)。新月体性组外周血mDC占淋巴细胞的百分比、CD4^(+)CD25^(high)CD127^(low)Treg细胞占CD4^(+)细胞的百分比均较局灶性组、混合性组下降(P<0.05)。结论外周血mDC和CD4^(+)CD25^(high)CD127^(low)Treg细胞下降与MPA患者疾病活跃度及肾组织急性病理损伤有关。Objective To investigate the correlation between the levels of myeloid dendritic cells(mDC),and regulatory T cells(Treg)in peripheral blood of patients with microscopic polyangiitis(MPA)and the Birmingham vasculitis activity score(BVAS)as well as the pathological damage of kidney tissue.Methods Twenty-seven patients with active MPA(MPA active group)and 18 patients with MPA in remission(MPA remission group)were selected,and 15 healthy volunteers with matching gender and age were selected as a control group.The percentage of mDC in lymphocytes and the percentage of Treg cells in CD4+cells in peripheral blood were detected by using flow cytometry three-color analysis.The mDC was defined as Lin1^(-)HLA-DR^(+)CD11c^(+),and Treg was defined as CD4+CD25highCD127lowTreg cells.According to WHO pathological diagnosis criteria,24 MPA patients with renal biopsy were divided into focal type group(n=12),crescent type group(n=5)and mixed type group(n=7).Results The percentage of mDC in lymphocytes and the percentage of CD4^(+)CD25^(high)CD127^(low)Treg in CD4+cells in peripheral blood in the MPA active group were lower than those in the MPA remission group and the control group(P<0.05).The proportions of mDC,and CD4^(+)CD25^(high)CD127^(low)Treg cells were negatively correlated with BVAS score(P<0.05).The percentage of mDC in lymphocytes and the percentage of CD4^(+)CD25^(high)CD127^(low)Treg cells in CD4^(+)cells in the crescentic group were lower than those in the focal group and the mixed group(P<0.05).Conclusion The decreased levels of mDC and CD4^(+)CD25^(high)CD127^(low)Treg cells in peripheral blood are related to disease activity and acute pathological injury of kidney tissue in MPA patients.

关 键 词：显微镜下多血管炎 髓样树突状细胞 调节性T细胞 

分 类 号：R587.1[医药卫生—内分泌]