CD_(28)/TLA4共刺激分子在多发性硬化免疫发病机制中的作用

The Role of CD_(28)/TLA-4 Costimulatory Molecules in the Pathogenesis of Multiple Sclerosis Immunity

目的探讨CD28、CTLA-4在多发性硬化免疫发病机制中的作用。方法选择临床确诊的20例多发性硬化患者(10例发病期,10例缓解期)和10例正常人。以流式细胞术分别分析其外周血CD3+T细胞膜表面CD28和CTLA-4的表达率。比较3组患者的外周血CD3+T细胞膜表面CD28和CTLA-4的表达率及CD28/CTLA-4比值。结果 3组的外周血CD3+T细胞膜表面CD28、CTLA-4的表达率、CD28/CTLA-4比值间差异均有统计学意义(P<0.05)。发病期CD28,CD28/CTLA-4比值均高于其他两组(P<0.05);CTLA-4低于其他两组(P<0.05)。多发性硬化患者CD28/CTLA-4比值与Th1/Th2比值有关联。结论①多发性硬化患者外周血CD3+T细胞膜表面共刺激分子表达异常,T细胞处于"预激活"状态;②CD28、cTLA4表达失衡可引起Th细胞格局偏移,Th1型细胞增多;③CD28、CTLA4与多发性硬化的发生、发展有关。

Objective To investigate the role of CD28,CTLA-4 in the immune pathogenesis of multiple sclerosis immunity.Methods 20 patients with clinically diagnosedh multiple sclerosis（10 cases onset period,10 cases in remission）and 10 normal subjects were analyzed by flow cytometry of peripheral blood CD3 ＋T cell surface CD28 and CTLA-4 expression rate.Peripheral blood CD3 ＋T cell surface CD28 and CTLA-4 expression rate and CD28/CTLA-4 ratio of the three groups were compared.Results The peripheral blood CD3 ＋T cell surface CD28,CTLA-4 expression rate,CD28/CTLA-4 were statistically significantly different（P0.05）.Onset phase CD28,CD28/CTLA-4 ratios are higher than the other two groups（P0.05）;CTLA-4 lower than the other two groups（P0.05）.Patients with multiple sclerosis CD28/CTLA-4 ratio is associated with Th1/Th2 ratio.Conclusion ①multiple sclerosis patients with CD3 ＋T cell surface expression of costimulatory molecules abnormal,T cells in a ＂pre-active＂ state;②CD28,cTLA4 expression imbalance can cause Th cells pattern offset,Thl-type cells increased;③CD28,CTLA-4 are correlated with multiple sclerosis occurrence and development.