SAPHO综合征患者辅助性T细胞17及调节性T细胞免疫特征及临床意义  

Immunological characteristics and clinical significance of helper T cell 17 and regulatory T cell in patients with SAPHO syndrome

作　　者：赵星涛 马彦[1] 杨静[1] 冯文莉[1] Zhao Xingtao;Ma Yan;Yang Jing;Feng Wenli(Department of Dermatology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院皮肤科,太原030001

出　　处：《中华风湿病学杂志》2025年第1期16-24,共9页Chinese Journal of Rheumatology

基　　金：国家自然科学基金面上项目(82072262)。

摘　　要：目的探讨SAPHO综合征患者外周血淋巴细胞亚群特别是辅助性T细胞17(Th17)、调节性T细胞(Treg)的免疫特征改变、细胞因子紊乱及其临床意义。方法回顾性分析2021年1月至2023年12月山西医科大学第二医院皮肤科及风湿免疫科收治的资料完整的53例SAPHO综合征患者作为研究对象。同时纳入年龄、性别匹配的55名健康者作为健康对照组。收集年龄、性别、临床表现、实验室检查等一般临床资料。采用流式细胞术检测外周血淋巴细胞亚群的绝对计数,流式液相多重蛋白定量技术(CBA)检测血清细胞因子的水平。采用秩和检验及Spearman相关性分析分别比较2组之间外周血淋巴细胞亚群及细胞因子差异,并进行相关性分析。结果①与健康对照组比较,SAPHO综合征患者总B细胞[240.77(180.65,303.87)个/μl和165.00(132.00,223.00)个/μl,Z=-3.25,P<0.001]、CD8+T细胞[504.6(381.43,735.36)个/μl和429.00(357.00,579.00)个/μl,Z=-2.71,P=0.007]、CD4+T细胞[898.47(755.61,1019.68)个/μl和637.00(544.00,819.00)个/μl,Z=-3.94,P<0.001]绝对计数明显升高;NK细胞[212.59(123.02,307.72)个/μl和283.00(189.00,406.00)个/μl,Z=2.95,P=0.003]绝对计数降低;CD4+T亚群比较中Th1[159.56(105.01,233.09)个/μl和47.18(9.73,99.12)个/μl,Z=-6.52,P<0.001]、Th17细胞[17.88(12.97,23.69)个/μl和5.38(4.06,7.42)个/μl,Z=-7.11,P<0.001]及Th17/Treg比值[0.59(0.38,0.84)和0.17(0.13,0.29),Z=-6.85,P<0.001]明显高于健康对照,差异具有统计学意义;而Th2[13.09(7.98,20.60)个/ml和10.22(5.36,15.60)个/ml,Z=-1.73,P=0.084]、Treg细胞[30.08(22.14,45.16)个/μl和33.58(22.15,42.13)个/μl,Z=0.07,P=0.985]水平比较2组差异无统计学意义。②按照是否有外周关节受累及皮肤表现进行亚组分析后各组之间淋巴细胞亚群比较差异均无统计学意义(P均>0.05)。③SAPHO综合征患者中Th17、Treg细胞及Th17/Treg与临床资料(血清中ESR、CRP、皮肤表现、关节症状)均无明显相关性(P均>0.05)。ObjectiveTo investigate the immunological characteristics,particularly the alterations in peripheral blood lymphocyte subsets,including Th17 and Treg cells,cytokine dysregulation,and their clinical significance in patients with SAPHO syndrome.MethodsFifty-three patients with SAPHO syndrome admitted to the Second Hospital of Shanxi Medical University from January 2012 to December 2023 in the department of dermatology and venereology and rheumatology with complete data were retrospectively analyzed as the study objects.At the same time,55 healthy subjects matched by age and sex were included as healthy control group.General clinical data such as age,sex,clinical manifestations and results of laboratory tests were collected.We employed flow cytometry to assess the absolute counts of peripheral blood lymphocyte subsets and utilized cytokines detected by the flow cytometry-based multiplex protein quantification technique(CBA)to measure serum cytokine levels.We compared the differences in peripheral blood lymphocyte subsets and cytokine levels between the two groups using the rank-sum test and Spearman correlation analysis.Results①Patients with SAPHO syndrome exhibited significantly elevated absolute counts of total B cells[240.77(180.65,303.87)/μl vs.165.00(132.00,223.00)/μl,Z=-3.25,P<0.001],CD8+T cells[504.6(381.43,735.36)/μl vs.429.00(357.00,579.00)/μl,Z=-2.71,P=0.007],and CD4+T cells 898.47(755.61,1019.68)vs.637.00(544.00,819.00),Z=-3.94,P<0.001],along with reduced NK cells[212.59(123.02,307.72)vs.283.00(189.00,406.00),Z=2.95,P=0.003].Compared with healthy controls,both Th1[159.56(105.01,233.09)/μl vs.47.18(9.73,99.12)/μl,Z=-6.52,P<0.001]and Th17 cells[17.88(12.97,23.69)个/μl vs.5.38(4.06,7.42)/μl,Z=-7.11,P<0.001]and the Th17/Treg ratio[0.59(0.38,0.84)vs.0.17(0.13,0.29),Z=-6.85,P<0.001]were significantly higher in the CD4+T subset,with statistical significant difference;however,no significant differences was observed in Th2[13.09(7.98,20.60)/μl vs.10.22(5.36,15.60)/μl,Z=-1.73,P=0.084]and Treg cell[30.0

关 键 词：获得性骨肥大综合征 TH17细胞 T淋巴细胞 调节性 细胞因子类 

分 类 号：R597[医药卫生—内科学]