Graves病病人外周血T淋巴细胞和甲状腺自身抗体的检测

CHANGES OF T LYMPHOCYTES SUBSET AND CHARACTERISTIC ANTIBODIES IN GRAVES' DISEASE

目的:观察Graves病病人外周血T细胞亚群、Th1/Th2细胞极化的变化,探讨细胞免疫在Graves病发病中的作用。方法:①采用流式细胞仪检测20例未经治疗的Graves病病人的T细胞亚群和CD8-/IFN-γ+细胞和CD8-/IL-4+T细胞的百分含量;②化学发光法检测FT3、FT4、s-TSH,放射免疫法检测TRAb、TGAb、TMAb;③观察Graves病病人经他巴唑(30mg/d)治疗1个月后T细胞亚群和CD8-/IL-4+T细胞和CD8-/IFN-γ+T细胞的百分含量的变化情况。结果:①Graves病病人较正常对照人群的CD4+T细胞与CD4+T细胞/CD8+T细胞比值增高;CD8-/IL-4+T(Th2)细胞的百分含量增高;CD8-/IFN-γ+T细胞/CD8-/IL-4+T细胞比值(Th1/Th2)下降(均P<0.05);②Graves病病人的FT3、FT4较正常对照组明显增高(均P<0.01),但s-TSH明显降低(P<0.01),TRAb、TGAb、TMAb明显增高(均P<0.05);③他巴唑治疗1个月后,T细胞亚群、CD8-/IL-4+T细胞和CD8-/IFN-γ+T细胞百分含量,以及CD8-/IFN-γ+T细胞/CD8-/IL-4+T细胞比值与治疗前相比均无显著差异。结论:在Graves病人外周血中Th2细胞亚群比例占明显优势,Th1/Th2细胞极化向Th2偏移,甲状腺特异的自身抗体增高,证明Graves病的发病与Th2型细胞介导的体液免疫直接相关。

Objective：To clarify the T cell subset difference and characteristic antibodies in patients with untreated Graves disease compared with healthy controls. Methods： （1）T cell subset, IFN-γ T lymphocyte and the IL-4 lymphocyte in peripheral blood were assayed by flow cytometry; （2）FT3, FT4 and s-TSH were tested by the chemiluminescence. TRAb, TGAb and TMAb were examined by the radioactive immunization; （3） T cell subgroup and CD8^-/IL-4^＋ T cell, CD8^-/IFN-γ^＋T cell were also examined by flow cytometry after Graves patients were took Tapazol （30mg/day） one month. Results：（1）CD4^＋ T cells in Graves disease patients were higher than those in healthy control,but CD8^＋ T cells were lower （ P 〈0.05）. Calculated ratio of FN-γ^＋/ IL-4^＋ T cellcytokines in Graves disease patients was lower than that in healthy controls. （2） Compared with healthy group, FT3,FT4 and TRAb,TGAb,TMAb were higher（ P〈0.01, P 〈0.05）, s-TSH was lower than controls （ P 〈0.01）. （3）Graves disease patients treated by Tapazol one month later, T Lymphocyte subpopulation and Th1/Th2 cytokineare no significantly changed. Conclusion： Th2 cytokine response dysfunction enhancement in Graves disease patient＇s peripheral blood compare with health adults. Thyroid gland special antibodies are higher. These findings further clarify that Th2 T cells and humoral immunity play a pivotal role in the pathogenesis of Graves disease.