系统性红斑狼疮骨髓T细胞活化及其与病情活动的相关性分析

Study of bone marrow T-lymphocyte activation in patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者骨髓T淋巴细胞的活化状态及多种活化的T细胞亚群与疾病活动指标之间的相关性。方法SLE患者11例(其中活动期6例,非活动期5例)和健康对照8名。应用流式细胞术比较活动期和非活动期SLE患者骨髓T细胞CD25、人类白细胞抗原(HLA)-DR的表达。用直线相关分析活化T细胞亚群与SLE疾病活动性评分(SLEDAI)、尿蛋白定量(24h)、血清补体C3、C4的相关性。结果活动期SLE、非活动期SLE与正常对照相比骨髓T细胞CD25、HLA-DR的表达,差异均无统计学意义(P>0.05)。活动期SLE骨髓T细胞HLA-DR^+、CIM^+HLA-DR^+、CD8+HLA-DR^+的表达均明显高于正常对照外周血(P<0.05)。11例SLE患者骨髓CD3^+HLA-DR^+、CD4^+HLA-DR^+细胞与C3之间均呈显著负相关(r=-0.682,r=-0.675,P均<0.05);CD3^+HLA-DR^+、CD8^+-HLA-DR^+细胞与尿蛋白定量(24h)之间均呈显著正相关(r=-0.712,r=-0.688,P均<0.05)。活动期SLE骨髓CD3^+HLA-DR^+、CD8^+HLA-DR^+细胞与C3之间均呈显著负相关(r=-0.943,r=-0.829,P均<0.05)。结论活动期SLE患者骨髓T细胞活化明显高于正常对照外周血,且骨髓中活化的T细胞与疾病活动指标相关。

Objective To investigate the activation of bone marrow T-lymphocytes in systemic lupus erythematosus （SLE） and its correlation with lupus activity. Methods T cell activation of bone marrow cells of 11 patients （active in 6, inactive in 5） with SLE was studied. Eight healthy volunteers were analyzed as controls. Tricolor fluorescence cytometry was used to measure the expression of CD25, HLA-DR on T cells. Flow cytometric data was expressed as the median positive percentage± SD. One-way analysis of variance was used to analyze differences among groups. Linear correlation was applied to assess relationships between immunophenotype results and clinical data. Results The expression of HLA-DR^＋ and CD25^＋ on T ceils of bone marrow （BM） had no significant difference among the active group, the inactive group and the control group （P〉0.05）. In active SLE, the CD3^＋HLA-DR^＋, CD4^＋HLA-DR^＋ and CD8^＋ HLA-DR^＋ cells of BM were all higher than those of peripheral blood in the control group （P〈0.05）. There was significant negative correlation between CD3＋HLA-DR~ cells of BM and serum C3 levels （r=-0.682, P〈0.05）, as well as CD4＋HLA-DR~ with C3 level （r=-0.675, P〈0.05）, but significant positive correlation between CD3＋HLA-DR^＋ cells of BM and 24 hours urine protein in 11 SLE patients （r=0.712, P〈0.05）. There was also significant positive correlation between CD8^＋HLA-DR^＋ cells of BM and 24 hours urine protein in 11 SLE patients （r=0.688, P〈0.05）. In active SLE （n=6）, there was significant negative correlation between CD3^＋HLA-DR^＋ cells of BM and serum C3 levels （r=-0.943, P〈0.05）, as well as CD8^＋HLA-DR^＋ with C3 （r=-0.829, P〈0.05）. Conclusions BM T cells in active SLE are more activated than those of peripheral blood in the control group. CD3^＋HLA-DR^＋ cells of BM in SLE are correlated with lupus activity.