系统性红斑狼疮患者CD4^+ CD25^+调节性T细胞及其细胞因子的改变

The Change of CD4^+ CD25^+ Regulatory T Cells and Cytokine in SLE Patients

目的探讨系统性红斑狼疮(SLE)患者CD4+CD25+调节性T细胞(Tr)及其细胞因子的改变。方法用流式细胞仪直接免疫荧光法检测SLE患者外周血CD4+CD25+T细胞的百分率,FoxP3+分子表达,细胞因子IL-10,TGF-β1的表达。结果 SLE患者活动期组、稳定期组、健康对照组CD4+CD25+T细胞占CD4+T细胞的百分率分别是(3.57±1.45)%,(5.14±1.63)%,(6.03±1.96)%。活动期患者明显低于稳定期患者和健康对照组,差异均有统计学意义(P均<0.05)。CD4+CD25+FoxP3+T细胞、CD4+CD25-FoxP3+T细胞占CD4+T细胞的百分率,活动期患者明显高于稳定期患者和健康对照组,差异均有统计学意义(P<0.05)。CD4+CD25+FoxP3+T细胞与疾病的活动指数(DAI)正相关(r=0.659,P<0.05);而CD4+CD25-FoxP3+T细胞与DAI无统计学相关性(r=0.184,P>0.05)。活动期患者CD4+CD25+IL-10+细胞明显高于稳定期患者和健康对照组,差异均有统计学意义(P均<0.05)。然而CD4+CD25-TGF-β+细胞在活动期患者、稳定期患者和健康对照组之间比较差异无统计学意义(P均>0.05)。结论 SLE患者外周血中Tr细胞数量减少,分泌的IL-10增加,TGF-β减少,可能导致细胞免疫抑制功能减弱,自身免疫耐受平衡被打破,出现激活的自身反应性T细胞增多;此外,T淋巴细胞激活增多,还可辅助B细胞产生更多相关抗体,表现出多种临床症状。

Objective To investigate the change of CD4 ＋ CD25 ＋ regulatory T cells and cytokine in SLE. Methods The direct assay was used to detect CD4＋ CD25 ＋ T cell, FoxP3 ＋ , IL-10 and TGF-β1 by flow cytometry. Results The percentage of CD4＋ CD25＋ T cell in active stage[ （3.57 ± 1.45）% ] was lower than that in remissive stage [ （5.14 ± 1.63） % ] and the control [ （6.03 ± 1.96） % ] （P 〈 0.05）. The percentage of CD4 ＋ CD25 ＋ FoxP3 ＋ Tcell and CD4＋ CD25- FoxP3 ＋T cell in active stage were higher than that in remissive stage and control（P 〈0.05）. There was positive relationship between CD4 ＋ CD25 ＋ FoxP3 ＋ T cell and SLE- DAI （ r = 0.659, P 〈 0.05）. However, no correlation was found between CD4 ＋ CD25 - FoxP3＋ T cell and SLE- DAI （ r = 0. 184, P 〉 0. 05 ）. CD4 ＋ CD25 ＋ IL- 10 ＋ T cell increased in active stage （ P 〈 0.05 ）, but there was no statistical significance of CD4 ＋ CD25 - TGF-β ＋ T cell in active stage , remissive stage and the control （ P 〉 0.05）. Conclusion The regulatory T cell. and the secretion of TGF-β decreased, and IL-10 increased in SLE patients , which lead to the celluar immunological inhibition function disorder, the breakage of autoimmunological tolerance and the increment of active autoreactive T cell. Moreover, T cell could help B cell produce more relative antibody, which lead to the manifestion of multiple clinical symptoms.