Graves病患者^(131)I治疗前后CD4^+CD25^+ Foxp3^+调节性T细胞的变化

The change of CD4^+CD25^+ Foxp3^+ regulatory T cells in peripheral blood of patients with Graves' disease treated by iodine-131

目的:通过对Graves病患者131I治疗前后外周血各淋巴细胞亚群和CD4+CD25+ Foxp3+调节性T细胞含量以及相关基因Foxp3mRNA表达水平的测定,探讨131I治疗方法是否可以通过改变调节性T细胞的含量从而改善Graves病患者的免疫功能异常。方法:采集30例Graves病患者131I治疗前及治疗后1个月的外周血,流式细胞仪检测外周血CD3+、CD3+CD4+、CD3+CD8+、CD3-CD19+、CD3-CD16+CD56+淋巴细胞亚群及CD4+CD25+ Foxp3+调节性T细胞的百分率,Real-TimePCR检测外周血单个核细胞Foxp3mRNA的表达水平。结果:和治疗前相比,Graves病患者131I治疗1个月后外周血CD3+CD4+T细胞和CD3-CD19+B细胞百分率都明显减少(P<0.05),CD3-CD16+CD56+NK细胞百分率明显增加(P<0.05),CD3-CD8+T细胞、CD4+CD25+ Foxp3+调节性T细胞百分率和Foxp3mRNA的表达水平无明显变化。结论:131I不能通过增加调节性T细胞的含量而改善Graves病患者的免疫耐受障碍,但可以通过减少CD4+T和B淋巴细胞的含量和增加NK细胞的含量来控制过度的免疫应答。

Objective：To explore whether 131I reverted the immune disorder of Graves′ disease（GD） via changing the proportion of CD4＋CD25＋ Foxp3＋ regulatory T cells（Tregs）,we evaluated the peripheral lymphocyte subsets,Tregs and the expression of Foxp3 mRNA from GD patients before 131I administration and in the first month after 131I administration.Methods：Thirty GD patients treated by 131I were included in this study.The proportion of lymphocyte subsets in the peripheral blood from GD before 131I administration and in the first month after 131I administration were detected by flow cytometric analysis.Real-time polymerase chain reaction was performed also to measure the expression of Foxp3mRNA.Results：Compared to GD patients before 131I administration,the proportion of CD3-CD19＋ B and CD3＋CD4＋T lymphocytes was significantly lower（P0.05）,and the proportion of CD3-CD16＋CD56＋NK lymphocytes was significantly higher in GD patients in the first month after 131I administration（P0.05）,the proportion of CD3-CD8＋ T lymphocytes,Tregs and the expression of Foxp3mRNA could not be changed remarkably.Conclusion：Iodine-131 might not alleviate impairment of immunological tolerance via increasing the proportion of Tregs,while it might control excessive immunological response via decreasing the proportion of CD3-CD19＋ B and CD3＋CD4＋T lymphocytes and increasing the proportion of NK lymphocytes.