糖皮质激素对重症肌无力患者外周血T淋巴细胞Fas表达的影响

The influences of glucocorticoid treatment on the Fas expression in peripheral blood T lymphocyte subsets in patients with myasthenia gravis

目的 探讨糖皮质激素治疗重症肌无力（MG）与Fas介导的细胞凋亡的关系.方法 选择17例MG患者,其中6例接受糖皮质激素治疗（糖皮质激素治疗组）,11例未接受糖皮质激素治疗（无糖皮质激素治疗组）;另选择同期健康自愿献血者13例作为健康对照组,采用流式细胞技术检测三组外周血T淋巴细胞表面CD4、CDs及Fas的表达.结果 糖皮质激素治疗组外周血T淋巴细胞表面CD4-CD8＋表达高于健康对照组[（36.75±11.56）%比（26.31±9.00）%],CD4-CD8-表达低于健康对照组[（30.56±9.72）%比（42.96±11.54）%],差异有统计学意义（P=0.027、0.018）;糖皮质激素治疗组外周血T淋巴细胞表面CD4-CD8＋表达高于无糖皮质激素治疗组[（36.75±11.56）%比（25.24±7.63）%],差异有统计学意义（P=0.019）.糖皮质激素治疗组外周血T淋巴细胞表面Fas＋、CD8＋Fas＋表达高于健康对照组[（46.10±7.13）%比（31.22±13.00）%,（62.86±12.29）%比（45.59±11.50）%],差异有统计学意义（P=0.006、0.003）.糖皮质激素治疗组CD8＋Fas＋表达高于无糖皮质激素治疗组[（62.86±12.29）%比（50.84±8.31）%],差异有统计学意义（P=0.034）.结论 糖皮质激素治疗对MG患者外周血T淋巴细胞亚群分布具有影响.Fas介导的细胞凋亡可能是糖皮质激素治疗MG的机制之一.

Objective To investigate the relation between Fas-mediated apoptosis and glucocorticoid treatment in myasthenia gravis （MG）. Methods In 17 patients with MG, 6 patients received glucocorticoid treatment （glucocorticoid treatment group）,and 11 patients were treated without glucocorticoid （nonglucocorticoid treatment group）. Meanwhile, 13 healthy cases were selected as healthy control group. CD4,CD8 and Fas expressions in peripheral blood T lymphocyte were detected by flow cytometry in three groups and analyzed. Results The percentage of CD4-CD8＋ cells in peripheral blood T lymphocyte in glucocorticoid treatment group was significantly higher than that in healthy control group[（36.75 ± 11.56）% vs. （26.31 ±9.00）%, P = 0.027], while the percentage of CD4-CD8- cells was significantly lower [（30.56 ± 9.72）% vs.（42.96 ± 11.54）%, P =0.018]. The percentage of CD4-CD8＋ cells in peripheral blood T lymphocyte in glucocorticoid treatment group was significantly higher than that in non-glucocorticoid treatment group [（36.75 ± 11.56）% vs. （25.24 ±7.63）% ,P =0.019]. The percentages of Fas＋ and CD8 ＋Fas＋ cells in peripheral blood T lymphocyte in glucocorticoid treatment group were significantly higher than those in healthy control group[（46.10 ± 7.13）% vs. （31.22 ± 13.00）%, P=0.006; （62.86 ± 12.29）% vs. （45.59 ±11.50）%, P = 0.003]. The percentage of CD8＋ Fas＋ cells in peripheral blood T lymphocyte in glucocorticoid treatment group was significantly higher than that in non-glucocorticoid treatment group [（62.86 ± 12.29）%vs （50.84 ± 8.31 ）%, P = 0.034]. Conclusions Glucocorticoid treatment may have influence on peripheral blood T lymphocyte subsets in patients with MG. Fas-mediated apoptosis may be involved in the mechanism of glucocorticoid treatment in MG.