COPD病人外周血CD4^+CD25^+调节性T细胞检测及意义

DETECTION OF CD4^+CD25^+REGULATORY T CELLS IN PERIPHERAL BLOOD OF COPD PATIENTS

目的检测慢性阻塞性肺疾病(COPD)病人外周血中CD4+CD25+调节性T细胞(Treg)的频率及血清γ-干扰素(IFN-γ)、白细胞介素4(IL-4)浓度,探讨Treg在COPD发病中的免疫调节作用。方法采用流式细胞仪检测45例COPD急性发作期病人、33例COPD临床缓解期病人以及25例健康人外周血中Treg亚群的频率,ELISA法检测血清中IFNγ-、IL-4浓度。结果 COPD病人急性发作期组IL-4浓度较临床缓解期组和健康对照组显著增高,临床缓解期组低于健康对照组,差异有统计学意义(F=192.86,q=11.63~27.66,P<0.01);COPD病人急性发作期组IFN-γ浓度高于临床缓解期组和健康对照组,差异有统计学意义(F=35.53,q=9.72、10.13,P<0.01),而临床缓解期组与健康对照组差异无统计学意义(q=1.13,P>0.05);临床缓解期组IFNγ-/IL-4比值最高,急性发作期组次之,健康对照组最低,差异有统计学意义(F=230.95,q=7.79~30.10,P<0.01);CD4+CD25+Treg频率在COPD急性发作期组高于临床缓解期组和健康对照组,而临床缓解期组低于健康对照组,差异有显著性(F=146.08,q=8.68~12.72,P<0.01)。结论 COPD病人存在Th1/Th2动态变化,急性发作期以Th2免疫为主,临床缓解期则以Th1免疫为主;Treg在COPD的发生发展中担负着重要的免疫调节作用。

Objective To detect the frequency of blood CD4^＋CD25^＋ regulatory T cells（Treg）,sereum IFN-γ and IL-4 in patients with chronic obstructive pulmonary disease（COPD）,and explore the immunoregulation of Treg in the development of COPD.Methods A flow cytometry was used to detect the frequency of Treg subgroup in 45 patients at acute attacks,33 in remission,and 25 healthy individuals;ELISA was used to determine their serum levels of IL-4 and IFN-γ.Results The level of IL-4 in acute-stage patients was significantly higher that in remission and the control;that in remission was lower than that in healthy controls,the differences being significant（F=192.86,q=11.63-27.66,P〈0.01）.The level of IFN-γ in acute episode was higher than that in remission and the control,the difference being significant（F=35.53;q=9.72,10.13;P〈0.01）,whereas the difference of that between the remission and the control was not significant（q=1.13,P〉0.05）.The proportionality of IFN-γ/IL-4 was the highest in the remission,acute attack came next,and the lowest in healthy controls,with a statistical difference（F=230.95,q=7.79-30.10,P〈0.01）.The frequency of CD4^＋CD25^＋ Treg was higher in acute phase than that in clinical remission phase and the control,whereas that in the remission was lower than that of the control（F=146.08,q=8.68-12.72,P〈0.01）.Conclusion There are dynamic changes of Th1/Th2 ratio in patients with COPD： during acute episode,Th2 immunity plays the key role;during remission,it is Th1 that does.Treg plays an important immuno-regulation in the occurrence and development of COPD.