可诱导共刺激分子在系统性红斑狼疮病人外周血T细胞亚群的表达及与临床的关系

Expression and clinical significance of inducible co-stimulator on peripheral blood T lymphocyte subsets in patients with systemic lupus erythematosus

目的 检测可诱导共刺激分子(inducibleco stimulator,ICOS)及相关免疫分子在SLE病人外周血T细胞亚群的表达,探索其与SLE疾病活动程度、病程及血清抗dsDNA抗体和免疫球蛋白含量间的关系,为进一步研究ICOS在SLE免疫病理中的作用奠定基础。方法 采用流式细胞术检测第二军医大学附属长海医院住院和门诊SLE患者 (n=51)以及健康体检者 (n=30)外周血T细胞亚群表面ICOS及其他免疫分子CD45RO、CD45RA、HLA DR的表达水平,观察ICOS在不同细胞亚群表达水平与SLE活动程度、病程、血清抗dsDNA抗体和血清免疫球蛋白含量间的关系。结果 与正常人相比,活动期及稳定期SLE患者外周血CD4+T细胞、CD8+T细胞表达ICOS的水平显著升高,但活动期患者与稳定期患者之间无统计学差异(P≥0 05);同一SLE患者在疾病活动期,外周血CD4+、CD8+、CD45RO+、CD4+CD45RO+和CD8+CD45RO+细胞表面ICOS的表达水平明显高于该患者经过治疗疾病缓解阶段(P<0 05);初发SLE患者CD45RO+细胞表达ICOS水平明显高于复发患者 (P<0 05);血清抗dsDNA抗体( +)及免疫球蛋白(IgG、IgM和IgA中任何一种 )异常升高的患者外周血CD45RO+及CD4+CD45RO+细胞表达ICOS的水平分别明显高于血清抗dsDNA抗体 ( -)和免疫球蛋白含量正常的患者(P<0 05)。

Objective To investigate the expression of inducible co stimulator (ICOS) and other immunological molecules on peripheral blood T lymphocyte subsets in patients with systemic lupus erythematosus (SLE) and to find out the relationship with disease activity, disease stage and the contents of anti dsDNA antibody and immunoglobulin in serum so as to pave the way for further studying the possibly immunologically pathological role of ICOS in SLE. Methods Peripheral blood samples were collected from 51 patients with SLE, 3 males and 22 females. Three color flow cytometry was used to detect the levels of ICOS, CD45RO, CD45RA, and HLA DR expression on the peripheral blood T lymphocytes subsets. The results were analyzed along with the disease activity, disease stage, contents of anti dsDNA antibody and immunoglobulin in serum. Thirty healthy subjects were used as controls.Results Compared with the healthy subjects the level of ICOS expression on the peripheral blood CD4 + and CD8 + T cells in the patients with SLE during active and stable stages were significantly increased (all P <0.05), but there was no significant difference between the last two group patients ( P ≥0.05); In the same patients, the level of ICOS expression on the peripheral blood CD4 + , CD8 + , CD45RO +、CD4 +CD45RO +and CD8 +CD45RO + cells in active stage were significantly increased compared with those in stable stage ( P <0 05); The level of ICOS expression on the peripheral blood CD45RO + cells in the untreated primary patients was higher than those with disease relapse ( P <0 05); The levels of ICOS expression on the peripheral blood CD45RO + and CD4 +CD45RO + cells were significantly increased in the patients with serum anti dsDNA antibody (+) and the patients with aberrantly high content of immunoglobulin compared with those of the patients with serum anti dsDNA antibody (-) and the patients with normal content of immunoglobulin, respectively (all P <0 05). Conclusion ICOS is aberrantly highly expressed on certain peripheral blood T lymphocyte subsets in patients with SLE, which is related to disease activity, disease stage and the contents of serum anti dsDNA antibody and immunoglobulin, thus ICOS may play a role in SLE pathogenesis.