类风湿关节炎患者CD8^＋IL-17^＋T细胞升高及其机制

Possible mechanisms of peripheral elevated CD8^＋IL-17^＋T cells in rheumatoid arthritis

目的探讨CD8^＋IL-17^＋T细胞在类风湿关节炎（RA）的改变及可能的机制。方法随机采集39例RA患者和40名健康人的外周血。以流式细胞术测定全部RA患者和27名健康人的外周血CD8^＋IL-17^＋T细胞的比例；以ELISA方法测定全部RA患者和健康人的血清白细胞介素（IL）-6、IL-23和IL-17水平，并分析这些指标可能的相互关系。结果RA患者CD8^＋IL-17^＋T细胞在CD8^＋T细胞的比例中位数为2．7％，95％可信区间为1．55％～3．74％；而正常人中位数为1．61％，95％可信区间为1．25％～2．61％。RA患者外周血CD8^＋IL-17^＋T细胞升高（P〈0．05）。对CD8^＋IL-17^＋T细胞功能相关的IL-17水平测定结果为，RA患者为（429±502）ng／L，而正常人仅为（13±30）ng／L（P〈0．01）。RA患者血清IL-17水平明显升高。对于CD8^＋IL-17^＋T细胞分化相关细胞因子的血清测定结果，IL-23水平在RA患者为（157．83±27．07）ng／L，正常人为（21．97±3．52）ng／L（P〈0．01）；IL-6水平在RA患者为（32．67±34．50）ng／L，正常人为（1．82±1．51）ng／L（P〈0．01）；RA患者血清IL-6、IL-23水平明显升高。结论RA患者CD8^＋IL-17^＋T细胞数量增多，作用增强，IL-6和IL-23的升高是引起这些改变的可能原因。

Objective To identify interleukin-17 （ IL-17 ）-producing CD8 positive T cells from patients with rheumatoid arthritis （ RA ） , and investigate its cytokines as well as their correlations. Methods Peripheral blood got from 39 RA patients and 40 healthy donors. Flow cytometry was used to analyze the subsets of T cells in peripheral blood from these 39 RA patients and 27 healthy donors. 11-17, IL-6, and IL- 23 levels in sera of all these people were tested by ELISA. Results The median of CD8^＋IL-17^＋T cells from RA patients was 2. 7% （ 95% confidence internal was 1.55% - 3.74% ） ; the median of these cells from healthy controls was 1.61% （95% confidence internal was 1.25% - 2. 61% ）. CD8^＋IL-17^＋T ceils elevated significantly in RA（ P 〈 0. 05 ）. As the production of CD8^＋IL-17^＋T cells, the IL-17 levels in sera of RA patients and healthy controls were （429 ± 502） ng/L and （13 ± 30） ng/L respectively. The IL-17 level in RA is higher than that in healthy people （ P 〈 0. 01 ）. Meanwhile, to constitute CD8^＋IL-17^＋T cell polarizing condition, IL-23 and IL-6 in sera of RA were （ 157. 83 ± 27. 07 ） ng/L and （32. 67± 34. 50） x ng/L individually. These two cytokines in healthy controls were （21.97 ± 3.52） ng/L and （1.82± 1.51 ） ng/L severally. IL-6 and IL-23 increased clearly in peripheral blood of RA patients as compared with healthy donors （ P 〈 0. 01 ）. Conclusions This study suggested that elevated CD8^＋IL-17^＋T cells which involved in IL-17 secretion may depend on increased IL-6 and IL-23 in peripheral blood of rheumatoid arthritis.