重症肌无力患者末梢血Th1和Th2细胞内细胞因子的变化及意义

The study of Th1 and Th2 cytokines in myasthenia gravis patients

目的研究重症肌无力(MG)患者末梢血细胞因子及抗乙酰胆碱受体抗体(AchRab)水平,探讨细胞因子在MG发病中的作用。方法研究对象为17例MG患者,分为急性期组10例,非急性期组7例,设健康对照组15例。应用流式细胞术(FCM)测定末梢血产生各型细胞因子(CK)的CD4+T细胞%,采用酶联免疫吸附法(ELISA)测定血清中抗乙酰胆碱受体抗体(AchRab)。结果⑴MG患者急性期组和非急性期组IFN-γ+IL-4-CD4+T细胞%及AchRab的含量比健康对照组显著增多(P<0.05和P<0.001);⑵急性期组和非急性期组IFN-γ-IL-4+和IL-13+CD4+T细胞%比健康对照组显著减少(P<0.05);⑶IL-10+CD4+T细胞%各组之间无显著性差异;⑷各组IFN-γ+IL-4-CD4+T细胞%与AchRab均呈正相关。结论MG患者Th1和Th2细胞因子的平衡紊乱,Th1细胞因子IFN-γ对MG患者自身抗体的产生有促进作用。

Objective To investigate the role of various intracellular cytokines in the pathogenesis of myasthenia gravis （MG）, the level of cytokines and AchRab in the peripheral blood were measured. Methods In this study the patient group included 10 acute cases and 7 non-acute cases; the control group induded 15 healthy people. CD4＋ T cells with different cytokines were measured by flow cytometry （FCM）. Enzyme-linked immunosorbent assay （ELISA） was used to measure the concentration of AchRab. Results （1） the percentage of IFNγ＋IL-4-CD4＋ T cells and the concentration of AchRab in patients with acute and non-acute MG were increased markedly compared with patients with normal controls （P〈0.05 and P〈0.001）; （2） a significant decrease of IFNγ-IL-4＋ and IL-13＋ levels was detected in acute and non-acute MG as compared with normal controls （P〈0.05）; （3） the percentage of IL-10＋CD4＋ T cell had no significant difference among these groups ; （4） the percentage of IFNγ＋IL-4-CD4＋T cells was directy related to AchRab in all groups. Conclusion We concluded that there was an unbalance between Th1 and Th2 in MG and Th1 cytokine IFNγ might contribute to AchRab production.