系统性红斑狼疮患者外周血辅助性T细胞亚型和细胞因子的检测及其临床意义

Detection of subtypes of T helper cells and their cytokines in peripheral blood of patients with systematic lupus erythematosus and their clinical significances

目的:探讨系统性红斑狼疮(SLE)患者外周血中产生白细胞介素22(IL-22)的辅助性T细胞(Th)亚型Th22、Th17和Th1及其细胞因子的表达水平变化及其临床意义,为治疗SLE提供依据。方法:选取30例初发SLE患者(SLE组)和30名健康对照者(健康对照组),采用流式细胞术检测2组研究对象外周血中Th22、Th17(IL-22+Th17和IL-22-Th17)、Th1(IL-22+Th1和IL-22-Th1)细胞表达比率;ELISA法检测2组研究对象血浆中IL-22、IL-17和干扰素γ(IFN-γ)等细胞因子的表达水平;细胞比率和细胞因子表达水平之间相关性分析采用Spearman相关检验。结果:与健康对照组比较,SLE组患者外周血中IL-22+Th1、Th17和Th22细胞的比率明显升高(P<0.05),SLE患者血浆中IL-17和IL-22的表达水平亦明显升高(P<0.05);SLE患者Th22细胞比率与Th17(IL-22+和IL-22-)细胞比率之间呈正相关关系(r=0.721,P<0.0001;r=0.222,P=0.0132),Th22细胞比率与血浆中IL-22的水平呈正相关关系(r=0.0326,P<0.0001)。SLE患者IL-22+CD4+T和IL-22-Th17细胞的比率随着疾病活动指数(SLEDAI)的升高而升高(r=0.549,P=0.0003;r=0.231,P=0.028)。有颜面部红斑或脱发、抗核抗体(ANA)阳性的SLE患者外周血中Th22细胞的比率均显著升高(P<0.05);光过敏或抗dsDNA阳性的SLE患者Th17(包括IL-22+和IL-22-Th17)细胞的比率上升(P<0.05)。结论:以Th22为主的IL-22+CD4+T细胞及其细胞因子IL-22可能在SLE的发病中起致病性作用,并可作为监测疾病严重程度的生物指标。

Objective To explore the changes and clinical significanees of subtypes of T helper cells Th22, Th17, and Thl, which can produce interleukin 22 （IL-22） and their cytokines in peripheral blood of the patients with systematic lupus erythematosus （SLE）, and to provide basis for SLE treatment. Methods 30 patients with new onset SLE（SLE group） and 30 healthy controls（healthy control group） were selected. The expression ratios of Th22, Th17 （IL-22^＋ Th17 and IL-22^- ThlT）, Thl（IL-22^＋ Thl and IL-22^- Thl）cells in peripheral blood of the objects were compared by flow eytometry; while the levels of plasma IL-22, IL-17, and interferon γ（IFN-γ） in the patients and healthy controls were measured by EL1SA method; the correlation between the ratios of cells and the expression levels of cytokines was analyzed by Spearman correlation test. Results Compared with healthy control group, the ratios of Th22, Th17, and IL-22^＋ Thl cells in peripheral blood of the patients in SLE group were siginificantly higher than those in healthy control group（P〈0.05）, and the expression levels of plasma IL-22 and IL-17 Of the patients in SLE group were also inereased（P〈0.05）. A statistically significant positive correlation was found between the ratios of Th17 （IL-22^＋ , IL-22^-） and Th22 cells of the patients in SLE group（r= 0. 721, P〈 0. 0001; r=0. 222, P=0. 0132）. The ratio of Th22 cells was positively correlated with the level of plasma IL-22 of the patients in SLE group （r=0. 0326, P〈0. 0001）. The ratios of IL- 22^＋ CD4^＋ T and IL-22 Th17 cells in peripheral blood of the patients in SLE group were increased along with the increasing of the disease activity score of SLE （SLEDAI）（r=0. 549, P=0. 0003; r=0. 231 P=0. 028）. The ratios of Th22 cells in the peripheral blood of the SLE patients with facial erythema or hair loss, and positive anti nuclear antibody（ANA） were increased （P〈 0.05）. The ratios of Th17 cells （including IL-22^＋ and IL-22^- Th17） in the SLE patients with light allergies or positive anti dsDNA were also increased （P〈0.05）. Conclusion The IL-22^＋ CD4^＋ T cells mainly including Th22 cells and their cytokine IL-22 may play an important role in the pathogenesis of SLE, which can be used as a bio- indicators for monitoring disease severity.