共刺激分子异常介导寻常型银屑病免疫失衡的实验研究

Immune abnormalities mediated by co-stimulatory molecules in patients with psoriasis vulgaris

目的通过检查外周血免疫细胞共刺激分子和细胞因子表达格局,分析寻常性银屑病患者可能发生的免疫异常。方法选择未经治疗的寻常型银屑病患者与正常对照组,抽取外周血并分离单个核细胞(peripheral bloodmonocytes,PBMC),采用RT-PCR对寻常型银屑病患者和正常对照组外周血CD86、B7H1、Foxp3、T-bet、GATA-3指标进行检测。采用流式细胞仪检查两组外周血清中IL-12、IFN-γ、IL-17、IL-2、IL-10、IL-9、IL-22、IL-6、IL-13、IL-4、IL-5、IL-1β、TNF-α含量。结果寻常型银屑病组PBMC中Foxp3和GATA3表达低于正常人群,但T-bet表达增高(P<0.05)。寻常型银屑病患者TNF-α明显高于正常对照组(P<0.05)。寻常型银屑病患者CD86相对表达量(0.3636±0.1003)明显高于对照组(0.1061±0.03883)(P<0.05);而B7H1相对表达量(0.06876±0.03145)明显低于对照组(0.3401±0.1152)(P<0.05)。结论寻常型银屑病患者Th1亚群增加、TNFa水平增高,而Th2和调节性T细胞(Regulatory T cells,Treg)亚群明显降低;寻常型银屑病患者外周血抗原递呈细胞(antigen present cells,APC)表达共刺激分子CD86增加而共抑制分子B7H1降低,提示寻常型银屑病患者体内存在的免疫功能紊乱可能是由于其APC功能异常所致。

Objective To investigate the immune abnormalities in patients with psoriasis vulgaris.Methods Blood samples were collected from 10 untreated patients with psoriasis vulgaris and 10 healthy subjects,and peripheral blood monocytes（PBMCs） were isolated.Expressions of CD86,B7H1,Foxp3,T-bet and GATA-3 were detected by RT-PCR and serum IL-12,IFN-γ,IL-17,IL-2,IL-10,IL-9,IL-22,IL-6,IL-13,IL-4,IL-5,IL-1β and TNF-α were measured by flow cytometry.Results The expressions of Foxp3 and GATA3 in psoriasis patients was lower,but expression of T-bet was higher than those in normal controls（P0.05）.Cytokine analysis indicated that TNF-α in psoriasis patients was significantly higher than that in normal controls（P0.05）.The expression of CD86 in psoriasis was 0.3636±0.1003,which was significantly higher than that in normal controls（0.1061±0.03883,P0.05）;while the expression of B7H1 was lower than that in control group（0.06876±0.03145 vs 0.3401±0.1152）（P0.05）.Conclusion Th1 subset and TNF-α levels in psoriasis increase,while Th2 and Treg subsets significantly reduce.The expression of co-stimulatory molecule CD86 in PBMCs of psoriasis patients increases;while inhibitory molecule B7H1 decreases,indicating that immune dysfunc-tion in psoriasis patients may be mediated by co-stimulating molecules of antigen presenting cells（APCs）.