重症肌无力患者外周血干扰素-γ和白细胞介素-10分泌性T细胞检测

Detection of IFN-γ and IL-10 secreting T cells in peripheral blood in patients with myasthenia graivs

目的探讨重症肌无力（MG）患者乙酸胆碱受体（AChR）特异性T细胞免疫应答及其与乙酸胆碱受体抗体（AChRAb）间的关系，及该类T细胞在胸腺瘤切除前后的变化。方法采用酶联免疫斑点（Elispot）技术在15例MG患者（AChRAb，阳性8例，阴性7例）和10例其他神经疾病（OND）患者中，检测外周血AChR等不同抗原特异性干扰素－γ（IFN-γ）分泌性Th1细胞和白细胞介素－10（IL－10）分泌性Th2细胞数。结果AChRAb阳性组MG患者外周血AChR特异性IFNY－γ、IL－10分泌细胞数量明显高于Ab阴性组及OND组（均P＜0．01）；AChRAb阴性组AChR见特异性IFN－γ、IL－10分泌细胞数均高干OND组（均P＜0．05）；胸腺切除术后15d该类细胞变化不明显。结论MG患者无论为AChRAb阳性或阴性，均存在AChR特异性T细胞激活，IFN－γ、IL－10在MG自身抗体的产生中起重要调节作用。

Objective To explore the specific T-cell mediated immunity against AChR and the relation with AChRAb in patients with MG, and the changes of these T cells before and after the thymectomy. Method Th1-related IFN-γ, Th2-related IL-10 secreting cells numbers stimulated by different antigen in 15 patients with MG (8 patients with positive AChRAb and 7 patients with negative AChRAb) and 10 patients with other neurological diseases (OND) were determined with Elispot assay. Results The number of IFN-γ and IL-10 secreting cells stimulated by AChR in the peripheral blood in MG patients with positive AChRAb were significantly higher than those with negative AChRAb(P<0.01). The number of IFN-γ and IL-10 secreting cells in groups with negative AChRAb were higher than OND patients (P<0.05). No significant of IFN-γ and IL-10 secreting T cells was found in about 15 days after thymectomy. Conclusion The abnormal specific T cell mediated immunity against AChR was found in the patients with MG, and specific AChR reactive IFN-γ and IL-10 secreting T cells play an important role in the antibody production.