CD19^(+)CD24^(+)CD27^(+)调节性B细胞在系统性红斑狼疮患者中的临床意义  

Clinical significance of CD19^(+)CD24^(+)CD27^(+) Breg cells in systemic lupus erythematosus patients

作　　者：朱捷 吴蕙 顾梅秀 潘柏申 郭玮 王蓓丽 ZHU Jie;WU Hui;GU Mei-xiu;PAN Bai-shen;GUO Wei;WANG Bei-li(Department of Laboratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Laboratory Medicine,Zhongshan Hospital Xiamen Branch,Fudan University,Xiamen 361015,Fujian Province,China)

机构地区：[1]复旦大学附属中山医院检验科,上海200032 [2]复旦大学附属中山医院厦门医院检验科,厦门361015

出　　处：《复旦学报（医学版）》2023年第1期26-31,70,共7页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金面上项目(81772263,81972000);国家自然科学基金青年项目(81902139);复旦大学附属中山医院临床研究专项基金(2018ZSLC05,2020ZSLC54);上海市临床重点专科建设项目(shslczdzk03302);厦门市医疗卫生重点项目(YDZX20193502000002);上海市医学重点专科建设计划(ZK2019B28)。

摘　　要：目的 探究CD19^(+)CD24^(+)CD27^(+)调节性B细胞在系统性红斑狼疮(systemic lupus erythematosus,SLE)中的作用和临床相关性。方法 收集23例SLE患者和23例健康人群的外周血以及血浆标本,使用流式细胞仪检测并比较两组人群外周血标本中的CD19^(+)CD24^(+)CD27^(+)调节性B细胞与细胞内IL-10的表达水平,并将其细分为CD24^(high)CD27^(+)以及CD24^(mid)CD27^(+)两个亚群,同时比较血浆中各细胞因子的浓度并分析其与Breg细胞的相关性。检测治疗后SLE患者外周血中Breg细胞的变化并与治疗前进行比较,分析其与疾病发展状态之间的关系。结果 SLE患者体内的两种Breg细胞均显著升高,分别为6.09%±2.61%和12.28%±4.90%,其细胞内IL-10表达也明显增强,且CD24^(high)CD27^(+)型Breg细胞内IL-10水平高于CD24^(mid)CD27^(+)型亚群。患者血浆中IL-1β为(9.24±9.97) pg/mL,IL-10为(43.50±23.06) pg/mL,TNF-α为(11.26±7.48) pg/mL,IFN-γ为(12.83±7.27) pg/mL,较正常人均显著升高,且IL-10浓度与CD24^(mid)CD27^(+)型亚群细胞比例存在正相关。外周血中两种Breg细胞均与患者的疾病状态存在关联,经过临床药物治疗后,患者体内的Breg细胞显著下降。结论 SLE患者外周血中调节性B细胞显著升高,其分泌的IL-10相应增高,免疫调控作用增强。经过治疗,两者显著下降,提示其具有反映患者疾病状态的潜在价值。Objective To explore the role and clinical relevance of CD19^(+)CD24^(+)CD27^(+)regulatory B(Breg)cells in systemic lupus erythematosus (SLE).Methods Peripheral blood and plasma from 23patients with SLE were collected,as well as 23 healthy individuals.Flow cytometry was used to detect and compare the CD19^(+)CD24^(+)CD27^(+)Breg cells and intracellular expression level of IL-10 in the peripheral blood samples from the two groups.These cells were subdivided into two subgroups of CD24^(high)CD27^(+)and CD24^(mid)CD27^(+).The concentration of variety of cytokines in plasma was compared and its correlation with Breg cells was analyzed.The change of Breg cells in the peripheral blood of SLE patients after treatment was also compared with those before treatment.Results The expression of two types of Breg cells (6.09%±2.61%vs.12.28%±4.90%) in SLE patients were significantly increased when compared with health individuals,as well as the intracellular IL-10 expression,and the expression of IL-10 in CD24^(high)CD27^(+)Breg cells was higher than that of CD24^(mid)CD27^(+)Breg cells.In patients with SLE,IL-1β was(9.24±9.97) pg/m L,IL-10 was(43.50±23.06) pg/m L,TNF-α was(11.26±7.48)pg/m L and IFN-γ was(12.83±7.27) pg/m L,all of which were significantly increased compared with healthy individuals,and the concentration of IL-10 was positively correlated with the proportion of CD24midCD27^(+)cells.Both types of Breg cells in peripheral blood are associated with the disease state of patients,and they would be significantly reduced after proper clinical treatment.Conclusion The regulatory B cells in the peripheral blood of patients SLE were significantly increased,and the IL-10 secreted from Breg cells also increased,enhancing immune status of SLE patients.After treatment,both of them decreased significantly,which can be used to reflect the disease state of patients.

关 键 词：系统性红斑狼疮(SLE) 疾病状态 IL-10 CD24^(high)CD27^(+)型Breg细胞 CD24^(mid)CD27^(+)型Breg细胞 

分 类 号：R593.241[医药卫生—内科学]