表达PD-1受体的Tfh细胞促进复发-缓解型多发性硬化急性期发作  

Relationship between expression of PD-1 receptor on surface of follicular helper T lymphocytes and pathogenesis of multiple sclerosis

作　　者：傅增辉 林再红 金艳 姜岩 刘晶 于绘丽 张广萍 FU Zenghui;LIN Zaihong;JIN Yan;JIANG Yan;LIU Jing;YU Huili;ZHANG Guangping(Department of Neurology,the Third Affiliated Hospital of Qiqihar Medical University,Qiqihar 161002,China)

机构地区：[1]齐齐哈尔医学院附属第三医院神经内科,齐齐哈尔161002

出　　处：《中国免疫学杂志》2023年第6期1307-1311,共5页Chinese Journal of Immunology

基　　金：齐齐哈尔市科技计划联合引导项目(LSFGG-2023004)。

摘　　要：目的:探讨多发性硬化(MS)患者外周血滤泡辅助性T淋巴细胞表面PD-1受体表达及其与临床特征的关系。方法:研究人群包括43例复发-缓解型MS急性期发作患者和43例健康志愿者,流式细胞仪检测CD4+CXCR5+CCR7^(lo)PD-1^(hi)T细胞,ELISA检测血清IL-21水平。对MS患者治疗前、治疗后4周进行扩展残疾状况评分量表(EDSS)评分并统计头颅MRI增强病灶数目。结果:MS患者治疗后较治疗前EDSS评分降低(P<0.05),但头颅MRI增强病灶数目无明显变化(P>0.05)。MS患者CD4+CXCR5+T细胞中CCR7^(lo)PD-1^(hi)亚群细胞比例及血清IL-21水平明显高于健康对照组(均P<0.05),且治疗后两者均降低(均P<0.05)。MS患者MOG-IgG和MBP-Ab表达阳性者CD4+CXCR5+T细胞中CCR7^(lo)PD-1^(hi)亚群细胞比例均高于抗体阴性者(均P<0.05)。MS患者治疗前外周血中CCR7^(lo)PD-1^(hi)在CD4+CXCR5+T细胞中表达比例与治疗前EDSS评分、治疗前MRI增强病灶数目、治疗前血清中IL-21表达均具有明显的正相关性(均P<0.05)。结论:复发-缓解型MS患者外周血CD4+CXCR5+T细胞中CCR7^(lo)PD-1^(hi)亚群比例与血清IL-21表达增加,且与疾病活动度呈显著正相关。Objective:To explore the expression of PD-1 receptor on peripheral blood follicular helper T lymphocytes in patients with multiple sclerosis(MS)and its relationship with clinical characteristics.Methods:The study population included 43 patients with relapsing-remitting MS and 43 healthy volunteers.CD4+CXCR5+CCR7^(lo)PD-1^(hi)T cells were detected by flow cytometry,and serum IL-21 levels were detected by ELISA.Before treatment and 4 weeks after treatment,MS patients were scored by the Extended Disability Status Score Scale(EDSS)and the number of brain MRI enhancement lesions was counted.Results:After treatment,the EDSS score of MS patients was lower than that before treatment(P<0.05),but the number of brain MRI enhancement lesions did not change significantly(P>0.05).The ratio of CCR7^(lo)PD-1^(hi) subgroup cells in CD4+CXCR5+T cells in MS patients and the level of serum IL-21 were significantly higher than those in healthy controls(P<0.05),and both decreased after treatment(P<0.05).The ratio of CCR7^(lo)PD-1^(hi) subgroup cells in CD4+CXCR5+T cells with positive MOG-IgG and MBP-Ab expression in MS patients was higher than that in antibody-negative patients(P<0.05).The expression ratio of CCR7^(lo)PD-1^(hi) in CD4+CXCR5+T cells in the peripheral blood of MS patients before treatment was significantly positively correlated with the EDSS score before treatment,the number of MRI-enhanced lesions before treatment,and the expression of IL-21 in serum before treatment(P<0.05).Conclusion:The proportion of CCR7^(lo)PD-1^(hi) subsets in CD4+CXCR5+T cells in patients with relapsing-remitting MS increase the expression of serum IL-21,and is significantly related to disease activity.

关 键 词：多发性硬化 程序性死亡受体1 滤泡辅助性T细胞 白细胞介素-21 

分 类 号：R741.05[医药卫生—神经病学与精神病学]