糖皮质激素对重度溃疡性结肠炎患者淋巴细胞粘附分子表达的影响

Effect of glucocorticoid on lymphocyte adhesion molecule phenotype expression in patients with ulcerative colitis

目的：研究糖皮质激素在分子水平抑制溃疡性结肠炎（ＵＣ）免疫反应和白细胞粘附的机制。方法：采用双标记免疫荧光染色和流式细胞仪，分析２０例中重度ＵＣ患者应用泼尼松治疗前后淋巴细胞粘附分子表型的变化。结果：①中重度ＵＣ患者ＣＤ＋４ＣＤ＋２９、ＣＤ＋８ＣＤ＋１１ａ、ＣＤ＋８ＣＤ＋１８、ＣＤ＋２０ＣＤ＋５４细胞均明显高于正常对照组（Ｐ均＜０．０１）；好转治愈组１６例治疗后上述指标明显下降；除ＣＤ＋２０ＣＤ＋５４细胞外，其余指标与正常对照组比较均无显著性差异（Ｐ均＞０．０５）；无效恶化组４例治疗前后上述指标均无明显变化（Ｐ均＞０．０５），且仍明显高于正常对照组（Ｐ均＜０．０１）。②中重度ＵＣ患者ＣＤ＋４ＣＤ＋１１ａ、ＣＤ＋４ＣＤ＋１８细胞均较正常对照组明显降低（Ｐ均＜０．０１）；好转治愈组治疗后均显著升高（Ｐ均＜０．０１），与正常对照组比较差异均无显著性（Ｐ均＞０．０５）。无效恶化组治疗后上述指标均无明显变化（Ｐ均＞０．０５），仍显著低于正常对照组（Ｐ均＜０．０１）。结论：糖皮质激素可能通过抑制部分淋巴细胞粘附分子的表达来抑制ＵＣ患者自体免疫过程。

Objective:To study the effect of glucocorticoid (GC) on lymphocyte adhesion molecule phenotype expression in patients with ulcerative colitis(UC).Methods:Using flow cytometric analysis and dual immunofluorescence staining method,lymphocyte adhesion molecule phenotype were examined in 20 severe UC patients before and after treatment with GC.Results:①CD+4,CD+29,CD+8CD+11a,CD+8CD+18,and CD+20CD+54 cells were much higher in UC patients than in normal controls (all P<001).After treatment with GC,they were restored to normal range in cure patients with an exception of CD+20CD+54 cells.However,no marked changes in phenotypes were found in noneffective patients following GC treatment,which were still much higher than those in normal controls (all P<001).② On the other hand,there was a significant reduction in CD+4CD+11a and CD+8CD+18 cells in UC patient compared to normal controls (both P<001),but they were markedly increased in cure patients after treatment.(P<001),and were no significant change in noneffective patients.Conclusions:GC may have beneficial effect in the treatment of UC by inhibiting the expression of lymphocyte adhesion molecule phenotype.