CD28表达与幼年特发性关节炎发病的相关性研究

Association between CD28 expression and juvenile idiopathic arthritis

目的探讨CD28在幼年特发性关节炎（juvenileidiopathicarthritis，JIA）活动期及疾病静息期变化的意义。方法利用流式细胞仪技术检测36例初发JIA患儿治疗前和疾病稳定后外周血CD4＋、CD8＋T细胞表面CD28的表达。结果JIA患儿疾病活动期外周血CD4＋T细胞CD28＋表达显著低于正常对照组（P〈0．01），CD8＋T细胞CD28’表达显著低于正常对照组（P〈0．01）；JIA患儿疾病活动期外周血CD28-表达的CD4＋T细胞显著高于正常对照组（P〈0．01）；JIA患儿疾病活动期外周血CD4＋T细胞数量显著高于正常对照组，CD8＋T细胞显著减少（P〈0．01）；JIA患儿疾病静息期外周血CD4＋T细胞和CD8＋T细胞数量与正常对照组差异无统计学意义（P〉0．05）；JIA患儿疾病静息期外周血CD4＋T细胞CD28表达和CD8＋T细胞CD28表达与正常对照组差异无统计学意义（P〉0．05）。结论CD28-的表达水平可以作为JIA疾病活动期的指标之一；JIA患儿疾病活动期CD4＋T细胞、CD4＋CD28-T细胞出现凋亡障碍。

Objective To investigate the clinical significance of CD28 expression on peripheral blood T lymphocytes in children with juvenile idiopathic arthritis （JIA）. Methods Flow cytometry and u＇i-color direct immunofluorescence were used to examine CD3 ＋T lymphocyte subsets and CD28 expression in whole blood （ u- sing the no-wash method） from 36 children with JIA. Results During the active phase of disease,the frequency of CD28 ＋expression on both CD4 ＋ and CD8 ＋ T cells in the peripheral blood of children with JIA was signifi- cantly lower than in normal controls （ P 〈 0. 01 ）. The frequency of CD4 ＋ CD28 - T cells in the peripheral blood of children with JIA was significantly higher than in normal controls （ P 〈 0.01 ）. CD4＋ T cell counts in the pe- ripheral blood of children with JIA, which were mostly of the CD4 ~ CD28 - T cell subtype, were significantly higher than in normal controls （ P 〈 0. 01 ）, whereas the CD8＋ T cell count was significantly reduced （ P 〈 0. 01 ）. During the resting phase, CD4 ＋/CD8 ＋ T cell counts and CD28 expression in the peripheral blood of chil- dren with JIA were significantly different from normal controls （ P 〉 0.05 ）. Conclusions The frequency of CD4 ＋ CD28 - T cells can be used as an indicator of the active phase of JIA. CD4＋T cell and CD4＋ CD28 - T cell apoptosis was inhibited in JIA patients. These immune-active T lymphocytes with continued survival can promote the occurrence and development of JIA.