白细胞介素-7/CD127信号通路对重症肌无力患者CD_(8)^(+)T细胞的调控作用  

The regulation of interleukin-7/CD_(127) signaling pathway on CD_(8)^(+) T cells in patients with myasthenia gravis

作　　者：秦慧兵[1] 刘红钊[1] 贾传宇 张雪芳[1] 张小林[1] 程曼 Qin Huibing;Liu Hongzhao;Jia Chuanyu;Zhang Xuefang;Zhang Xiaolin;Cheng Man(Department of Neurology,Nanyang Central Hospital,Nanyang 473009,China)

机构地区：[1]南阳市中心医院神经内科,南阳473009

出　　处：《中华神经科杂志》2022年第6期597-604,共8页Chinese Journal of Neurology

摘　　要：目的研究重症肌无力(MG)患者白细胞介素-7(IL-7)/CD_(127)信号通路对CD_(8)^(+)T细胞的调控作用。方法收集2017—2020年在南阳市中心医院神经内科就诊的初治MG患者57例(MG组),同时入组健康对照者35名(健康对照组),采集两组受试者的外周血分离血浆和外周血单个核细胞,采用酶联免疫吸附试验(ELISA)检测血浆中IL-7和可溶型CD_(127)水平,用流式细胞术检测CD_(8)^(+)T细胞中膜型CD_(127)的表达比例,分析上述指标在不同性别和发病年龄、有无胸腺瘤、不同Osserman分型之间的差异及与定量重症肌无力(QMG)量表评分的相关性。纯化MG患者CD_(8)^(+)T细胞,使用重组人IL-7(5μg/L)刺激培养,比较可溶型CD_(127)和膜型CD_(127)的水平变化,ELISA法检测培养上清中穿孔素、颗粒酶B、干扰素-γ、肿瘤坏死因子-α(TNF-α)水平;采用实时荧光定量聚合酶链反应法检测CD_(8)^(+)T细胞中免疫检查点分子mRNA表达量。结果MG组血浆IL-7水平高于健康对照组[(293.4±74.7)pg/ml比(233.8±70.8)pg/ml,t=3.78,P<0.001],可溶型CD_(127)水平低于健康对照组[(102.7±13.7)pg/ml比(131.2±20.9)pg/ml,t=7.91,P<0.001]。MG组外周血CD_(8)^(+)T细胞比例高于健康对照组(35.4%±7.1%比30.2%±7.5%,t=3.31,P=0.001),膜型CD_(127)+CD_(8)^(+)T细胞比例亦高于健康对照组(45.5%±7.7%比34.7%±11.5%,t=5.44,P<0.001)。上述指标在不同性别之间、早发型和晚发型之间、非胸腺瘤组和胸腺瘤组之间、不同Osserman分型之间的差异均无统计学意义,与QMG量表评分均无明显相关性。IL-7刺激MG患者CD_(8)^(+)T细胞后,培养上清中可溶型CD_(127)水平、膜型CD_(127)+CD_(8)^(+)T细胞比例、免疫检查点分子mRNA表达水平与未经IL-7刺激时比较差异无统计学意义。经IL-7刺激后CD_(8)^(+)T细胞分泌穿孔素[(208.1±67.2)pg/ml]、颗粒酶B[(941.8±273.9)pg/ml]、干扰素-γ水平[(19.1±5.2)pg/ml]高于未经IL-7刺激时[分别为(168.8±46.2)pg/ml,t=2.16,P=0.038;(78Objective To investigate the modulatory function of interleukin-7(IL-7)/CD_(127) signaling pathway on CD_(8)^(+)T cells in patients with myasthenia gravis(MG).Methods Fifty-seven treatment-naive MG patients who were hospitalized in Department of Neurology,Nanyang Central Hospital between 2017 and 2020 as well as 35 healthy controls were enrolled.Peripheral blood was collected,while plasma and peripheral blood mononuclear cells were isolated.Plasma IL-7 and soluble CD_(127)(sCD_(127))were measured by enzyme linked immunosorbent assay(ELISA).Membrane-bound CD_(127)(mCD_(127))percentage in CD_(8)^(+)T cells was measured by flow cytometry.The differences of above indices between different gender,onset age,afflicting with thymoma,or different Osserman type and their correlation with Quantitative Myasthenia Gravis(QMG)score were analyzed.Purified CD_(8)^(+)T cells from MG patients were stimulated with recombinant human IL-7(5μg/L).Changes of sCD_(127) and mCD_(127) level were analyzed.Levels of perforin,granzyme B,interferon-γ(IFN-γ),and tumor necrosis factor-α(TNF-α)in the cultured supernatants were measured by ELISA.Immune checkpoint molecules mRNA in CD_(8)^(+)T cells was semi-quantified by real-time fluorescence quantitative polymerase chain reaction.Results Plasma IL-7 level was up-regulated in MG patients compared with controls[(293.4±74.7)pg/ml vs(233.8±70.8)pg/ml,t=3.78,P<0.001],while sCD_(127) level was down-regulated in MG patients compared with controls[(102.7±13.7)pg/ml vs(131.2±20.9)pg/ml,t=7.91,P<0.001].Peripheral CD_(8)^(+)T cells percentage was up-regulated in MG patients compared with controls(35.4%±7.1%vs 30.2%±7.5%,t=3.31,P=0.001),and mCD_(127)+CD_(8)^(+)T cell percentage was also elevated(45.5%±7.7%vs 34.7%±11.5%,t=5.44,P<0.001).There were no significant differences of above indices between different gender,onset age,afflicting with thymoma,or different Osserman type.There was no significant correlation between above indices and QMG score.There were no significant differences of sCD_(12

关 键 词：重症肌无力 白细胞介素7 CD8阳性T淋巴细胞 白细胞介素7受体α亚单位 

分 类 号：R746.1[医药卫生—神经病学与精神病学]