CD8^+调节性T细胞亚群在系统性红斑狼疮患者外周血中分布的初步研究

Analysis of peripheral blood CD8^+ regulatory lymphocytes from the patients with systemic lupus erythematosus

目的:研究系统性红斑狼疮(SLE)患者外周血CD8+CD28-调节性T细胞和CD8+CD28+效应性T细胞的比例,以及CD8+CD28-/CD8+CD28+细胞间的比值及其临床意义。方法:对37例SLE患者及15例健康对照新鲜外周全血以双抗体标记流式细胞术测定CD8+CD28-、CD8+CD28+T细胞亚群比例,计算CD8+CD28-/CD8+CD28+细胞间比值,并分析以上数据与SLE活动度、SLE活动性评分(SLEDAI)、免疫球蛋白增高或补体下降或肾损害的关系,观察激素治疗对以上数据变化的影响。结果:(1)稳定期SLE患者外周血CD8+CD28-T细胞群比例较正常对照及活动性SLE显著升高,而高活动性SLE患者CD8+CD28+T细胞群比例显著降低,同时CD8+CD28-/CD8+CD28+细胞间比值显著升高;(2)SLEDAI与CD8+CD28+T细胞亚群比例存在负相关(P<0.05),与CD8+CD28-/CD8+CD28+细胞间比值存在正相关(P<0.05);(3)SLE患者中补体水平降低者较补体水平正常者、有肾损害者较未发生肾损害者CD8+CD28-/CD8+CD28+细胞间比值显著升高;(4)对10例活动性SLE患者进行追踪,经激素治疗达到稳定期后,其CD8+T细胞、CD8+CD28-T细胞比例及CD8+CD28+T细胞比例均显著增高。结论:SLE患者体内免疫系统紊乱可表现在CD8+T细胞亚群比例改变上,其中CD8+CD28+T细胞群比例以及CD8+CD28-/CD8+CD28+细胞间比值改变可能反映了细胞免疫功能的紊乱,而CD8+CD28-调节性T细胞比例增高与病情活动的控制有关;CD8+CD28-/CD8+CD28+比值与病情活动性和补体异常及肾损害相关,可以作为病情监测的指标。

Objective： To investigate the percentages of peripheral blood CD8^＋CD28^- regulatory lymphocytes,CD8^＋CD28^＋ effector lymphocytes and the ratio of CD8^＋CD28^-/CD8^＋CD28^＋ T cells in the patients with systemic lupus erythematosus （SLE）, and to explore their clinical values. Methods： The peripheral blood CD8^＋CD28^-,CD8^＋CD28^＋ and the ratio of CD8^＋CD28^-/CD8^＋CD28^＋ T cells were measured by two antibody labeling flow cytometric analysis in 37 patients with SLE and 15 controls. The differences in SLEDAI, serum immunoglobulin, complement, kidney damage and the variance before and after hormonal therapy were also analyzed in SLE patients. Results： （1） Compared to controls, patients with non-active SLE had significantly higher percentage of peripheral blood CD8^＋CD28^- T cells, while patients with high-active SLE got significantly decreased percentage of peripheral blood CD8^＋CD28^＋T cells. （2） SLEDAI was negatively correlated with peripheral blood CD8^＋CD28^＋ T cells （P 〈 0.05） and positively correlated with the ratio of CD8^＋CD28^-/CD8^＋CD28^＋ T cells （P 〈 0.05）. （3） The ratio of CD8^＋CD28^-/CD8^＋CD28^＋＋ T cells was significantly higher in SLE patients with the decrease of complement or kidney damage. （4） After hormonal therapy for the 10 active SLE patients, the percentage of peripheral blood CD8^＋＋ T cells, the ratio of CD8^＋CD28^- to CD8^＋CD28^＋ T cells were significantly increased. Conclusion： Changes of the percentage of CD8^＋ T subsets and the ratio of CD8^＋CD28^-/CD8^＋CD28^＋ might be associated with the disorder of immune function of SLE patients. The increase of CD8^＋CD28^- T cells might be associatied with the control of SLE. The ratio of CD8^＋CD28-/CD8^＋CD28^＋ T cells, which is associated with the decrease of complement and kidney damage, could be considered as a mark of pathogenic monitor for SLE.