单核样髓源性抑制细胞在炎症性肠病中的表达及其临床意义

Expression and Significance of Monocytic Myeloid-derived Suppressor Cells in Inflammatory Bowel Disease

近年来炎症性肠病(IBD)发病率呈上升趋势,其病理生理学机制复杂且仍未明确。目的:研究单核样髓源性抑制细胞(MDSCs)在IBD患者外周血单核细胞中的比例,分析单核样MDSCs与IBD活动性的关系,从而初步探讨单核样MDSCs在IBD中的作用机制。方法:纳入IBD患者60例,分为克罗恩病(CD)组(n=33)和溃疡性结肠炎(UC)组(n=27),选取30名同期健康体检者作为正常对照组,采用流式细胞仪检测CD组、UC组、正常对照组患者外周血单核样MDSCs/单核细胞比例,分析单核样MDSCs与IBD患者WBC、PLT、ESR、CRP的相关性。结果:CD组和UC组外周血单核样MDSCs/单核细胞比例较正常对照组相比显著升高[(43.7±23.0)%、(49.1±27.2)%对(10.7±7.4)%](P<0.01),CD组与UC组相比差异无统计学意义(P>0.05)。活动期CD和UC组外周血单核样MDSCs/单核细胞比例均较缓解期组显著升高[(60.3±16.8)%、(66.3±17.6)%对(28.1±16.2)%、(19.9±9.0)%](P<0.01)。IBD患者外周血单核样MDSCs/单核细胞比例与WBC计数、PLT计数呈正相关(r=0.44,P=0.02;r=0.43,P=0.02),与ESR、CRP不相关(r=0.33,P=0.08;r=0.30,P=0.12)。结论:IBD患者外周血单核样MDSCs比例明显升高,与IBD活动性密切相关。单核样MDSCs在IBD发病中具有重要作用。

Background： The incidence of inflammatory bowel disease （IBD） was increasing recently. However, its pathologic mechanism is complicated and has not been fully clarified. Aims： To investigate the monocytic myeloid-derived suppressor cells （MDSCs） / monocyte ratio in peripheral blood of IBD patients, and analyze the relationship between monocytic MDSCs and the activity of IBD, so as to explore the role of monocytic MDSCs in the pathogenesis of IBD. Methods： A total of 60 patients with IBD were enrolled and assigned into Crohn＇ s disease （CD） group （n = 33） and ulcerative colitis （UC） group （ n = 27）. Thirty healthy subjects were served as normal controls. The monocytic MDSCs / monocyte ratio in peripheral blood in CD, UC and normal control groups were detected by flow cytometry, and the correlations between monocytic MDSCs and WBC, PLT, ESR, CRP were analyzed. Results： Compared with normal control group, the monocytic MDSCs / monocyte ratio in peripheral blood increased significantly in CD and UC groups [ （43.7± 23.0） % , （49.1± 27.2）% vs. （10.7± 7.4）% ] （P 〈 0.01 ）, and no significant difference was found between CD and UC groups （P 〉 0.05）. The monocytic MDSCs / monocyte ratio in active stage CD and UC groups were significantly higher than those in remission stage groups [ （60.3 ± 16.8） %, （66.3 ± 17.6） % vs. （28.1 ± 16.2） %, （ 19.9 ± 9.0） % ] （P 〈 0.01 ） .A positive correlation was found between monocytic MDSCs / monocyte ratio and peripheral WBC, PLT count （ r = 0.44, P = 0.02; r = 0.43, P = 0.02）, but no association was found between monocytic MDSCs/monocyte ratio and ESR, CRP （r = 0.33, P = 0.08 ; r = 0.30, P = 0.12）. Conclusions ： Monocytic MDSCs / monocyte ratio is increased markedly in IBD patients, which correlates closely to the activity of IBD, suggesting that monocytic MDSCs may play an important role in the pathogenesis of IBD.