自身免疫性胰腺炎与免疫抑制细胞的关系

Relationship between autoimmune pancreatitis and immune suppressor cells

目的通过对自身免疫性胰腺炎(autoimmune pancreatitis,AIP)与非AIP(non-autoimmune pancreatitis,nAIP)胰腺组织内调节性T细胞(regulatory T cells,Tregs)和髓源性抑制细胞(myeloid derived suppressor cells,MDSCs)的检测和比较,探讨免疫抑制细胞在AIP疾病过程中的作用,为临床病理诊断和鉴别诊断提供依据。方法采用荧光免疫双标记及免疫组化染色,检测81例纤维包块型胰腺炎(fibrous mass-forming chronic pancreatitis,FMCP)胰腺组织内CD11b+CD33+MDSCs与Foxp3+Tregs的浸润情况,其中包括20例AIP,61例nAIP。结果 AIP组与nAIP组胰腺组织内CD11b+CD33+MDSCs浸润数量分别为(12.22±10.87)个/HPF和(4.39±7.29)个/HPF,AIP组CD11b+CD33+MDSCs浸润数量明显多于nAIP组(P=0.000)。AIP组与nAIP组胰腺组织内Foxp3+Tregs浸润数量分别为(14.91±22.76)个/HPF和(8.12±10.92)个/HPF,两组间Foxp3+Tregs浸润数量差异无显著性(P=0.076)。结论 MDSCs在AIP胰腺组织内的累积水平显著高于nAIP,而二者胰腺组织内Tregs的累积水平差异无显著性,MDSCs和Tregs在胰腺组织内的累积可能是炎症反应所致。由于AIP与nAIP疾病性质不同,MDSCs和Tregs可能在AIP与nAIP的疾病过程中发挥不同作用,二者限制nAIP的炎症反应却可能促进AIP进展成为恶性疾病。

Purpose To detect and compare the number of regulatory T cells （Tregs） and myeloid derived suppressor eetls（MDSCs） within local pancreas of fibrous mass-forming chronic pancreatitis （FMCP） including autoimmune pancreatitis （AIP） and non-antoim-mune pancreatitis （nAIP） and to investigate the possible effect that immune suppressor cells probably have during the disease process of AIP, to provide evidence for clinicopathological diagnosis and differential diagnosis. Methods Immunofluoreseence staining and immunohistochemical staining were used to detect the number of CD11b ^＋ CD33^＋ MDSCs and Foxp3^ ＋ Tregs within pancreas of FMCP, respectively. Results CD11b^＋ CD33^ ＋ MDSCs within the pancreas of AIP and nAIP were （ 12.22 ± 10. 87）/high power field （HPF） and （4. 39 ± 7.29）/HPF, respectively, the number of CD11b ^＋ CD33^ ＋ MDSCs in AIP was much more than nAIP （P = 0. 000）. Foxp3^ ＋ Tregs within the pancreas of AIP and nAIP were （ 14.91 ± 22.76）/HPF and （8. 12 ± 10. 92）/HPF, respectively, the number of Foxp3^＋ Tregs between the two group had no significant difference （P = 0. 076）. Conclusions The number of MDSCs within the pancreas of AIP is much more remarkable than nAIP, however, that of Tregs between the two groups has no significant difference, and thus the accumulation of MDSCs and Tregs within the pancreas are probably the results of inflammatory response. Due to the different property of AIP and nAIP, MDSCs and Tregs may play a different role during the disease process of AIP and nAIP, both of them re-strain the inflammatory response in nAIP, however, they may facilitate AIP to progress into malignant disease.