糖皮质激素上调系统性红斑狼疮患者外周血CD4^+CD25^+T细胞CD62L的表达

Glucocorticoids treatment upregulates the expression of CD62L in CD4^+CD25^+T cells in peripheral blood monocytes of patients with systemic lupus erythematosus

目的探讨糖皮质激素(简称激素)治疗对系统性红斑狼疮(SLE)患者外周血CD4^+CD25^+T细胞(调节性T细胞)亚群CD62L表达的影响。方法采用流式细胞仪检测了10例初发未经治疗的SLE患者和25例经激素治疗后的SLE患者外周血CD4^+CD25^+T细胞亚群CD62L的表达,并与12例正常人对照组相比较。结果未经治疗的初发SLE患者CD62L^+和CD62L^-的CD4^+CD25^+T细胞均较健康对照组明显减少。激素治疗后,SLE患者外周血CD4^+CD25^+CD62L^+T细胞显著升高,而且与糖皮质激素剂量有关。大剂量激素治疗组CD4^+CD25^+CD62L^+T细胞显著高于未治疗组和正常人对照组,但小剂量激素治疗组CD4^+CD25^+CD62L^+T细胞仅高于未治疗组。然而无论小剂量激素治疗组还是大剂量激素治疗组的CD4^+CD25^+CD62L^-T细胞与正常人对照组比较差异均无统计学意义。SLE患者外周血CD4^+CD25^+CD62L^+ T细胞与疾病活动指数成负相关。结论糖皮质激素可能上调SLE患者外周血CD4^+CD25^+CD62L^+T细胞的生成.促进外周免疫耐受,从而缓解病情。

Objective To investigate the effect of glucocorticoids （ GC ） treatment on the expression of CD62L in CD4^＋ CD25^＋T cells in peripheral blood monocytes （ PBMC ） of patients with systemic lupus erythematosus （ SLE ）. Methods Flow cytometry was used to detect the expression of CD62L in CD4^＋ CD25^＋T cells in PBMC of 35 SLE patients （ 10 untreated, 25 treated with GC ） and 12 normal human controls. Results The frequencies of both CD4^＋CD25^＋ CD62L^＋T cells and CD4^＋CD25^＋ CD62L T cells were significantly decreased in untreated SLE patients compared with the controls [ （4.12 ±3.68 ）% vs （ 9.27 ±4.44）%, P〈 0.05 and （ 1.15 ±0.99）% vs （4.25 ±2.21 ）%, P〈 0.05]. The frequency of CD4^＋CD25^＋ CD62L^＋ T cells in SLE patients treated with GC increased greatly; this increase was related to the dose of GC. The frequency of CD4^＋ CD25^＋ CD62L^＋T cells in SLE patients treated with high-dose GC was higher than that in untreated SLE patients and normal controls [ （ 14.84 ± 6.41 ）% vs （4.12±3.68）%, P 〈 0.05 and （ 14.84 ± 6.41 ） vs （9.27 ±4.44 ）%, P 〈 0.05 ], while that in SLE patients treated with low-dose GC was only higher than that in untreated SLE patients [ （ 9.07 ± 5.27 ）% vs （ 4.12 ± 3.68 ）%, P 〈 0.05 ） ]. No difference was found in the frequency of CD4^＋ CD25^＋ CD25^＋T cells between either SLE patients treated with high-dose GC or those with low-dose GC and the controls. The frequency of CD4^＋CD25^＋ CD62L^＋ T cells had a negative correlation with disease activity of SLE （ SLEDAI ）. Conclusion GC treatment can decrease the disease activity in SLE by upregulating the generation of CD4^＋ CD25^＋ T cells, especially CD4^＋ CD25^＋ CD62L^＋T cells, hence promoting peripheral immunotolerance.