强直性脊柱炎患者外周血T细胞亚群极化状态的研究

Study of the polarization state of peripheral blood T cell subsets of patients with ankylosing spondylitis

目的:分析强直性脊柱炎患者外周血中T细胞亚群的极化状态,进一步阐明强直性脊柱炎的免疫学发病机制。方法:运用流式细胞(FCM)技术,通过CD3/CD4或CD3/CD8设门,检测早、晚期AS患者和健康对照者外周血淋巴细胞的CD3+CD4+CD30+、CD3+CD4+CD30-、CD3+CD8+CD30+、CD3+CD8+CD30-T细胞的百分率,分别表达Th1、Th2、Tc1、Tc2细胞,并进行比较分析。结果:在早期AS患者CD4+T细胞和CD4+T/CD8+T细胞的比值均明显低于健康对照组(P<0.05),Th1细胞百分率及Th1/Th2比值明显降低(P<0.05),CD8+T细胞的百分率明显高于健康对照组(P<0.05),Tc2细胞明显升高(P<0.05),且Tc1/Tc2比值明显降低(P<0.05);在晚期AS患者Tc2细胞明显升高(P<0.05),Tc1/Tc2比值明显降低(P<0.05)。结论:早期AS患者外周血CD4+T细胞、CD8+T细胞、CD4+T/CD8+T的变化与健康对照比较具有显著性意义,阐明了AS早期患者体内的免疫功能紊乱,呈现一种免疫功能低下的状态。重要的是Th1细胞、Th1/Th2、Tc1/Tc2的明显减少,提示在早期AS患者体内Th1/Th2、Tc1/Tc2的失调,且以Th2、Tc2占有优势,而晚期AS患者因Tc1/Tc2明显降低导致比例失衡,这些显示Th1/Th2、Tc1/Tc2的比例失衡可能是导致AS发病的重要因素,是AS发病机制之一。

Objective:To analyze the polarization state of peripheral blood T cells subsets of patients with ankylosing spondylitis(AS) and illuminate the immunologic pathogenesis.Methods:CD3+CD4+CD30+,CD3+CD4+CD30-,CD3+CD8+CD30+,CD3+CD8+CD30-T cells in peripheral blood of patients with AS and healthy controls was detected in CD3/CD4 or CD3/CD8 subsets by flow cytometry in order to reflect Th1/Th2,Tc1/Tc2 bins.Results:Compared with healthy control, the average percentage of CD4+T cells and the ratios of CD4+T/CD8+T in early stage of AS were decreased obviously (P<0.05),and the average percentage of Th1 cells as well as the ratios of Th1/Th2 were decreased obviously(P<0.05).Meanwhile the average percentage of CD8+T cells and Tc2 cells increased sharply(P<0.05). In advanced period, the average percentage of Tc2 increased sharply and the ratio of Tc1/Tc2 were decreased obviously (P<0.05).Conclusion:The changes of CD4+,CD8+T cells,CD4+T/CD8+T in early stage of AS are significant compared with controls, which indicates the disorder of immunofunctions.The changes suggest that the Th1/Th2 and Tc1/Tc2 are of imbalance in early stages of AS and Th2,Tc2 are predominant. In advanced stages of AS, the ratio of Tc1/Tc2 decreased obviously with Tc1/Tc2 imbalance.It is implied that the imbalance of Th1/Th2,Tc1/Tc2 might play an important role in AS and be involved in the pathogenesis of AS.