类风湿关节炎患者外周血CXCR5^(-)CD4^(+)T细胞上PD1表达及意义  

Expression of programmed death 1 on CXCR5^(-)CD4^(+)T cell from the patients with rheumatoid arthritis and clinical significance

作　　者：罗清[1] 涂丽娜 符碧琪[3] 李雪[1] 李俊明[1] Luo Qing;Tu Lina;Fu Biqi;Li Xue;Li Junming(Dept of Clinical Laboratory,The First Affiliated Hospital of Nanchang University,Nanchang 330006;Dept of Medical Technology,Nanchang Medical College,Nanchang 330052;Dept of Rheumatology,The First Affiliated Hospital of Nanchang University,Nanchang 330006)

机构地区：[1]南昌大学第一附属医院检验科,南昌330006 [2]南昌医学院医学技术学院,南昌330052 [3]南昌大学第一附属医院风湿免疫科,南昌330006

出　　处：《安徽医科大学学报》2022年第12期1891-1895,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:82160307);江西省重点研发计划项目(编号:20181BBG70013);江西省卫生厅课题(编号:202130158,20175074);江西省卫生计生委中医药科研课题(编号:2018A366)。

摘　　要：目的探讨程序性死亡分子1(PD1)在中国人群类风湿关节炎(RA)患者外周血趋化因子受体5(CXCR5)^(-)CD4^(+)T细胞上的表达及临床意义。方法应用流式细胞仪检测82例RA患者和46例健康对照者外周血CXCR5^(-)CD4^(+)T细胞上PD1表达水平,比较RA组和健康对照组之间CXCR5^(-)CD4^(+)T细胞上PD1表达水平,分析其与RA实验室检查指标的相关性。结果①RA患者CXCR5^(-)CD4^(+)T细胞PD1表达百分比和平均荧光强度(MFI)均高于对照组,差异有统计学意义(P<0.0001,U=1082;P<0.0001,U=917.5)。②RA患者外周血CXCR5^(-)CD4^(+)T细胞PD1表达百分比与类风湿因子(RF)(r_(s)=0.2679,P=0.0229)、升高的RF(r_(s)=0.419,P=0.0011)、升高的anti-CCP抗体(r_(s)=0.2607,P=0.0407)、浆母细胞比例(r_(s)=0.3024,P=0.0293)、疾病活动性评分(DAS28)ESR(r_(s)=0.2447,P=0.0427)呈正相关。③RA患者外周血CXCR5^(-)CD4^(+)T细胞PD1表达MFI与淋巴细胞计数(L)(r_(s)=-0.3387,P=0.0020)、L%(r_(s)=-0.3479,P=0.0014)、淋巴细胞与单核细胞比值(LMR)(r_(s)=-0.2637,P=0.0174)呈负相关;与中性粒细胞百分比(N%)(r_(s)=0.3047,P=0.0054)、中性粒细胞与淋巴细胞比值(NLR)(r_(s)=0.3411,P=0.0018)、血小板与淋巴细胞比值(PLR)(r_(s)=0.2321,P=0.0371)、系统性免疫炎症指数(SII)(r_(s)=0.2880,P=0.0091)、衍生中性粒细胞与淋巴细胞比值(dNLR)(r_(s)=0.3203,P=0.0036)、血沉(ESR)(r_(s)=0.2595,P=0.0193)、视觉模拟评分(VAS)(r_(s)=0.2416,P=0.0439)呈正相关。高活动组RA患者(DAS28-ESR>5.1)CXCR5^(-)CD4^(+)T细胞PD1表达MFI高于非高活动组(DAS28-ESR≤5.1),差异有统计学意义(P=0.0407,U=406.0)。结论RA患者外周血CXCR5^(-)CD4^(+)T细胞PD1表达异常,与疾病的抗体产生、浆母细胞比例、炎症程度及活动性有关。Objective To investigate the expression of programmed death 1(PD1)on CXCR5^(-)CD4^(+)T cells from the patients with rheumatoid arthritis(RA)and to analyze the clinical relevance to disease severity.Methods The expression of PD1 on CXCR5^(-)CD4^(+)T cells were examined from 82 RA patients and 46 healthy controls(HC)by the technique of flow cytometry.The expression of PD1 including mean fluorescence intensity(MFI)on CXCR5^(-)CD4^(+)T cells and percentage of PD1+CXCR5^(-)CD4^(+)T cells were compared between RA patients and HC.Moreover,its correlation with laboratory inspection was analyzed.Results①The percentage of PD1+CXCR5^(-)CD4^(+)T cells and the MFI of PD1 on CXCR5^(-)CD4^(+)T cells from RA patients were significantly elevated compared with HC(P<0.0001,U=1082;P<0.0001,U=917.5).②The percentage of PD1+CXCR5^(-)CD4^(+)T cells in RA patients were positively associated with rheumatoid factors(RF)(r_(s)=0.2679,P=0.0229),increased RF(r_(s)=0.419,P=0.0011),increased anti-cyclic citrullinated peptide(anti-CCP)(r_(s)=0.2607,P=0.0407),the percentage of plasmablasts(r_(s)=0.3024,P=0.0293),DAS28-ESR(r_(s)=0.2447,P=0.0427).③The MFI of PD1 on CXCR5^(-)CD4^(+)T cells in RA patients were negatively with lymphocytes number(r_(s)=-0.3387,P=0.0020),lymphocytes percentage(r_(s)=-0.3479,P=0.0014),lymphocyte-to-monocyte ratio(r_(s)=-0.2637,P=0.0174).The MFI of PD1 on CXCR5^(-)CD4^(+)T cells in RA patients were positively associated with neutrophil percentage(r_(s)=0.3047,P=0.0054),neutrophilto-lymphocyte ratio(r_(s)=0.3411,P=0.0018),platelet-to-lymphocyte ratio(r_(s)=0.2321,P=0.0371),systemic immune inflammation index(r_(s)=0.2880,P=0.0091),derived Neutrophil to lymphocyte ratio(r_(s)=0.3203,P=0.0036),erythrocyte sedimentation rate(r_(s)=0.2595,P=0.0193),patient visual analogue scale(r_(s)=0.2416,P=0.0439).The MFI of PD1 on CXCR5^(-)CD4^(+)T cells from high active RA patients was significantly elevated compared with non-high active group(P=0.0407,U=406.0).Conclusion The abnormal expression of PD1 on CXCR5^(-)CD4^(+)T cells are

关 键 词：类风湿关节炎 CXCR5^(-)CD4^(+)T细胞 PD1 

分 类 号：R593.22[医药卫生—内科学]