阿尔茨海默病患者外周血CD45RO^(+)T细胞上CXCR3的表达和临床意义  

Expression and clinical significance of CXCR3 on effector T cells in the peripheral blood of patients with Alzheimer′s disease

作　　者：任壮壮 贾爽爽 钟晓玲 张玉凤 李婷婷[5] 邱峰 Ren Zhuangzhuang;Jia Shuangshuang;Zhong Xiaoling;Zhang Yufeng;Li Tingting;Qiu Feng(Naval Clinical College,Fifth School of Clinical Medicine,Anhui Medical University,Hefei 230032,China;Department of Neurology,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China;Department of Neurology,Huaihe Hospital,Henan University,Kaifeng 475000,China;Department of Neurology,the First Medical Center of PLA General Hospital,Beijing 100853,China;Department of Gastroenterology,the Second Medical Center of PLA General Hospital,Beijing 100859,China)

机构地区：[1]安徽医科大学第五临床医学院、海军临床学院,合肥230032 [2]解放军总医院第六医学中心神经内科,北京100048 [3]河南大学淮河医院神经内科,开封475000 [4]解放军总医院第一医学中心神经内科,北京100853 [5]解放军总医院第二医学中心消化内科,北京100859

出　　处：《中华内科杂志》2025年第4期339-343,共5页Chinese Journal of Internal Medicine

摘　　要：目的:初步探讨阿尔茨海默病(AD)患者外周血中CD45RO^(+)T细胞上C-X-C基序趋化因子受体3(CXCR3)的表达水平与临床特征的关系。方法:选取2022年9月到2024年3月于解放军总医院神经内科医学部就诊的AD患者41例(AD组),另选年龄、性别与AD组相匹配的健康对照者30名(健康对照组)。利用流式细胞术检测两组受试者外周血CD45RO^(+)T细胞亚群CXCR3的表达水平,采用简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估AD组患者痴呆程度。使用Spearman相关分析评估AD组CD45RO^(+)CXCR3^(+)T细胞水平与痴呆程度的相关性。应用受试者工作特征(ROC)曲线计算曲线下面积(AUC),评估外周血中CD45RO^(+)CXCR3^(+)T细胞能够预测AD的潜在价值。结果:AD组CD8^(+)CD45RO^(+)CXCR3^(+)T细胞水平显著高于健康对照组[17.8%(7.2%,40.3%)比8.2%(5.1%,12.3%),Z=-2.59,P<0.05]。AD组CD4^(+)CD45RO^(+)CXCR3^(+)T细胞、CD4^(+)CD45RO-CXCR3^(+)T细胞、CD8^(+)CD45RO-CXCR3^(+)T细胞与健康对照组相比差异无统计学意义(P>0.05)。Spearman相关分析显示,AD患者外周血中CD8^(+)CD45RO^(+)CXCR3^(+)T细胞与MMSE和MoCA评分呈现负相关(r=-0.72,P<0.05;r=-0.70,P<0.05)。CD8^(+)CD45RO^(+)CXCR3^(+)T细胞作为预测AD生物标志物的AUC为0.81,其预测敏感度为59.0%,特异度为93.3%。结论:CXCR3在AD患者外周血CD8^(+)CD45RO^(+)T细胞上表达水平显著升高。其中CD8^(+)CD45RO^(+)CXCR3^(+)T细胞水平与AD认知严重程度相关,对AD具有一定的预测价值。Objective:This study investigated the expression of C-X-C motif chemokine receptor 3(CXCR3)on CD45RO^(+)T cells in the peripheral blood of patients with Alzheimer′s disease(AD)and its association with clinical features.Methods:A total of 41 AD patients and 30 age-and sex-matched healthy controls(HCs)were recruited from the Department of Neurology at the Medical Division of PLA General Hospital between September 2022 and March 2024.Flow cytometry was used to quantify CXCR3 expression on CD45RO^(+)T cell subsets in peripheral blood.Dementia severity in AD patients was assessed using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA).Spearman correlation analysis examined the relationship between CD45RO^(+)CXCR3^(+)T cell levels and cognitive function in the AD group.Receiver operating characteristic(ROC)curve analysis determined the predictive utility of CD45RO^(+)CXCR3^(+)T cells for AD,quantified by the area under the curve(AUC).Results:Compared to healthy controls,AD patients exhibited significantly elevated levels of CD8^(+)CD45RO^(+)CXCR3^(+)T cells[17.8%(7.2%,40.3%)vs.8.2%(5.1%,12.3%),Z=-2.59,P<0.05].However,no significant differences were observed for CD4^(+)CD45RO^(+)CXCR3^(+)T cells,CD4^(+)CD45RO^(+)CXCR3^(+)T cells,or CD8^(+)CD45RO^(+)CXCR3^(+)T cells(P>0.05).Spearman correlation analysis revealed a negative correlation between CD8^(+)CD45RO^(+)CXCR3^(+)T cell levels and cognitive scores(MMSE:r=-0.72,P<0.05;MoCA:r=-0.70,P<0.05).ROC analysis demonstrated an AUC of 0.81 for CD8^(+)CD45RO^(+)CXCR3^(+)T cells in predicting AD,with a sensitivity of 59.0%and specificity of 93.3%.Conclusions:CXCR3 expression is significantly upregulated on CD8^(+)CD45RO^(+)T cells in AD patients,and its levels correlate with cognitive impairment severity.These findings suggest that CD8^(+)CD45RO^(+)CXCR3^(+)T cells may serve as a potential biomarker for AD diagnosis and progression monitoring.

关 键 词：阿尔茨海默病 CXCR3 T细胞 

分 类 号：R74[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]