重组人型肿瘤坏死因子受体-抗体融合蛋白治疗活动性强直性脊柱炎对患者T淋巴细胞亚群和单核细胞CD36表达的影响  

Effect of recombinant human tumor necrosis factor receptor-antibody fusion protein for treating active ankylosing spondylitis on T lymphocyte subsets and monocyte CD36 expression

作　　者：王倩 成善毅 罗斌[1] 李智伟[1] WANG Qian;CHENG Shanyi;LUO Bin;LI Zhiwei(Center of Clinical Laborator,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001,China;Xinjiang Medical University,Urumqi,Xinjiang 830011,China)

机构地区：[1]新疆维吾尔自治区人民医院临床检验中心,新疆乌鲁木齐830001 [2]新疆医科大学,新疆乌鲁木齐830011

出　　处：《国际检验医学杂志》2022年第11期1342-1347,1353,共7页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2020D01C091);新疆维吾尔自治区人民医院院内课题项目(20190116)。

摘　　要：目的 初步探讨重组人型肿瘤坏死因子受体-抗体融合蛋白(RhTNFR-Fc)治疗活动性强直性脊柱炎(AS)对患者外周血T淋巴细胞亚群及单核细胞CD36表达的影响。方法 选取2017年1月至2019年12月于新疆维吾尔自治区人民医院风湿科首次进行生物制剂治疗的活动性AS患者78例,将所有活动性AS患者按随机数字表法分为观察组和对照组,每组39例。其中对照组进行常规治疗,采用非甾体类药物口服治疗;观察组在常规治疗基础上应用RhTNFR-Fc治疗。根据BASDAI评分、BASFI评分、C反应蛋白(CRP)、红细胞沉降率(ESR)评估AS患者疾病活动度,判断转归情况。应用流式细胞学检测活动性AS患者治疗前后外周血T淋巴细胞亚群(Th1、Th2、Th17、Treg细胞)比例及单核细胞CD36荧光强度的变化。分析活动性评估指标与T淋巴细胞亚群和单核细胞CD36荧光强度的相关性。结果 与治疗前相比,观察组患者在治疗2、4、6个月后临床BASDAI评分、BASFI评分、CRP、ESR、Th1细胞比例、Th17细胞比例均明显下降(P<0.05),单核细胞CD36荧光强度增高(P<0.05)。治疗2、4、6个月观察组BASDAI评分、BASFI评分、Th17细胞比例均明显低于对照组(P<0.05),且观察组评分结果下降幅度明显大于对照组(P<0.05);而单核细胞CD36荧光强度在治疗2、4、6个月后观察组均高于对照组(P<0.05),且升高幅度大于对照组(P<0.05)。活动性AS患者外周血Th1、Th17细胞比例与骶髂关节CT分级、BASDAI评分和BASFI评分呈正相关(r>0,P<0.05);单核细胞CD36荧光强度与Th1细胞比例、Th17细胞比例、骶髂关节CT分级、BASDAI评分和BASFI评分呈负相关(r<0,P<0.05),与Th2细胞、Treg细胞比例呈正相关(r>0,P<0.05)。结论 RhTNFR-Fc蛋白联合非甾体类药物共同治疗活动性AS起效快,可有效缓解活动性AS临床症状,达到协同用药效果。Th1、Th17、Treg细胞可能用于RhTNFR-Fc治疗活动性AS的疗效监测,有助于临床了解患者�Objective To preliminarily explore the effect of recombinant human tumor necrosis factor receptor-antibody fusion protein(RhTNFR-Fc)for treating active ankylosing spondylitis(AS)on peripheral blood T lymphocyte subsets and the monocyte CD36 expression.Methods A total of 78 patients with active AS treated with the biological agents for the first time in the rheumatology department of Xinjiang Uygur Autonomous Region People′s Hospital from January 2017 to December 2019 were selected and divided into the observation group and control group according to the random number table method,39 cases in each group.The control group conducted the routine therapy by adopting oral non-steroidal drugs;on the basis of the routine therapy the observation group used RhTNFR-Fc.The active AS disease activity and outcome were evaluated according to the BASDAI score,BASFI score,C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR).The flow cytometry was used to detect the expression proportion of peripheral blood T lymphocyte subsets(Th1,Th2,Th17,Treg cells)and monocyte CD36 fluorescence intensity before and after treatment in the patients with active AS.The correlation between the activity assessment indicators with T lymphocyte subsets and monocyte CD36 fluorescence intensity was analyzed.Results Compared with before treatment,the clinical BASDAI score,BASFI score,CRP,ESR,Th1 cell ratio and Th17 cell ratio after treatment in the observation were significantly decreased(P<0.05),and the monocyte CD36 fluorescence intensity was increased(P<0.05).The BASDAI score,BASFI score,and Th17 cell ratio after 2,4,6 months of treatment in the observation group were significantly lower than those in the control group(P<0.05),moreover the decrease range of the scores in the observation group was significantly greater than that in the control group(P<0.05).Whereas the monocyte CD36 fluorescence intensity after 2,4,6 months of treatment in the observation group was higher than that in the control group(P<0.05),moreover the increase range wa

关 键 词：活动性强直性脊柱炎 重组人型肿瘤坏死因子受体-抗体融合蛋白 T淋巴细胞亚群 单核细胞CD36 

分 类 号：R446.11[医药卫生—诊断学]