系统性红斑狼疮患者外周血CXCR5^(-)CD4^(+)T细胞上PD1表达及意义  

xpression of programmed death 1 on CXCR5^(-) CD4^(+) T cell from the patients with systemic lupus erythematosus and clinical significance

作　　者：罗清[1] 张露 黄自坤[1] 符碧琪[2] 李俊明[1] Luo Qing;Zhang Lu;Huang Zikun;Fu Biqi;Li Junming(Dept of Clinical Laboratory,The First Affiliated Hospital of Nanchang University,Nanchang 330006;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》2023年第7期1103-1110,共8页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:82160308);江西省重点研发计划项目(编号:20181BBG70013);江西省卫生健康委科技计划(编号:202130158);江西省自然科学基金(编号:20171BAB205113)。

摘　　要：目的探讨程序性死亡分子1(PD1)在系统性红斑狼疮(SLE)患者外周血CXCR5^(-)CD4^(+)T细胞上的表达及临床意义。方法流式细胞术检测47例SLE患者、35例健康对照者(HC)外周血PD1^(+)CXCR5^(-)CD4^(+)T细胞百分率和CXCR5^(-)CD4^(+)T细胞PD1表达平均荧光强度(MFI),比较两组之间的差异,分析其与SLE临床、实验室指标、浆母细胞的相关性,并分析其预测SLE的价值。结果(1)SLE患者PD1^(+)CXCR5^(-)CD4^(+)T细胞百分率高于HC,差异有统计学意义(P=0.0083,U=540.5);SLE患者CXCR5^(-)CD4^(+)T细胞PD1表达MFI高于HC,差异有统计学意义(P<0.0001,U=187.0)。(2)SLE患者PD1^(+)CXCR5^(-)CD4^(+)T细胞百分率与补体C3(r_(s)=-0.3352,P=0.0228)、抗SSA抗体(P=0.0166,t=2.5)、抗组蛋白抗体(P=0.0303,t=2.3)、治疗(P=0.0202,t=3.4)、浆母细胞比例(r_(s)=0.3871,P=0.0072)相关;SLE患者CXCR5^(-)CD4^(+)T细胞PD1表达MFI与系统性红斑狼疮疾病活动性评分(SLE-DAI)(r_(s)=0.4031,P=0.0050)、红细胞沉降率(r_(s)=0.3561,P=0.0177)、C-反应蛋白(r_(s)=0.3374,P=0.0289)、红细胞(r_(s)=-0.2970,P=0.0426)、血红蛋白(r_(s)=-0.3029,P=0.0385)、血细胞比容(r_(s)=-0.3816,P=0.0081)、淋巴细胞计数(r_(s)=-0.3937,P=0.0062)、淋巴细胞百分比(r_(s)=-0.3912,P=0.0065)、中性粒细胞百分比(r_(s)=0.3150,P=0.0311)、NLR(r_(s)=0.3730,P=0.0098)、LMR(r_(s)=-0.4315,P=0.0025)、dNLR(r_(s)=0.3150,P=0.0311)、anti-Ro52(P=0.0295,t=63.5)、治疗(P=0.0355,W=21)、浆母细胞比例(r_(s)=0.3158,P=0.0306)相关。(3)逻辑回归分析显示CXCR5^(-)CD4^(+)T细胞PD1表达MFI是SLE的危险因素。(4)ROC曲线分析显示CXCR5^(-)CD4^(+)T细胞PD1表达MFI预测SLE的AUC为0.886,构建了基于CXCR5^(-)CD4^(+)T细胞PD1表达MFI和HGB的预测模型,预测模型的AUC为0.979,预测模型与SLEDAI呈正相关(r_(s)=0.3136,P=0.0303)。结论SLE患者升高的外周血PD1^(+)CXCR5^(-)CD4^(+)T细胞百分率、CXCR5^(-)CD4^(+)T细胞PD1表达MFI与疾病严重程度及活动性相关,且构建了基于CXCR5^(-)CD4^(+)TObjective To investigate the expression of programmed death 1(PD1)on CXCR5^(-)CD4^(+)T cells from the patients with systemic lupus erythematosus(SLE)and to analyze the clinical relevance to disease severity.Methods The expression of PD1 on CXCR5^(-)CD4^(+)T cells was examined from 47 SLE patients and 35 healthy controls(HC)by the technique of flow cytometry.The expression of PD1 including percentage of PD1^(+)CXCR5^(-)CD4^(+)T cells and mean fluorescence intensity(MFI)on CXCR5^(-)CD4^(+)T cells was compared between SLE patients and HC.And its correlation with clinical indicators,laboratory inspection and the percentage of plasmablasts was analyzed.Moreover,the predictive value of the expression of PD1 on CXCR5^(-)CD4^(+)T cell was explored.Results(1)The percentage of PD1^(+)CXCR5^(-)CD4^(+)T cells from SLE patients significantly elevated compared with HC(P=0.0083,U=540.5),and the MFI of PD1 on CXCR5^(-)CD4^(+)T cells from SLE patients significantly elevated compared with HC(P0.0001,U=187.0).(2)The percentage of PD1^(+)CXCR5^(-)CD4^(+)T cells was associated with C3(r_(s)=-0.3352,P=0.0228),anti-SSA(P=0.0166,t=2.5),anti-histone(P=0.0303,t=2.3),treatment(P=0.0202,t=3.4),plasmablasts(r_(s)=0.3871,P=0.0072)in SLE patients.The MFI of PD1 on CXCR5^(-)CD4^(+)T cells was associated with SLEDAI(r_(s)=0.4031,P=0.0050),ESR(r_(s)=0.3561,P=0.0177),CRP(r_(s)=0.3374,P=0.0289),RBC(r_(s)=-0.2970,P=0.0426),HGB(r_(s)=-0.3029,P=0.0385),HCT(r_(s)=-0.3816,P=0.0081),L(r_(s)=-0.3937,P=0.0062),L%(r_(s)=-0.3912,P=0.0065),N%(r_(s)=0.3150,P=0.0311),NLR(r_(s)=0.3730,P=0.0098),LMR(r_(s)=-0.4315,P=0.0025),dNLR(r_(s)=0.3150,P=0.0311),anti-Ro52(P=0.0295,t=63.5),treatment(P=0.0355,W=21),plasmablasts(r_(s)=0.3158,P=0.0306).(3)Logistic regression analysis showed that the MFI of PD1 on CXCR5^(-)CD4^(+)T cells was a risk factor for SLE.(4)ROC analysis showed the AUC of the MFI of PD1 on CXCR5^(-)CD4^(+)T cells was 0.886.A further established model based on combination of the MFI of PD1 on CXCR5^(-)CD4^(+)T cells and HGB showed predictive value in disti

关 键 词：系统性红斑狼疮 CXCR5-CD4^(+)T细胞 PD1 预测模型 

分 类 号：R593.24[医药卫生—内科学]