子痫前期患者辅助性T淋巴细胞及协同刺激分子CD28/CTLA-4的表达

Expressions of CD28 /CTLA-4 and T-auxiliary Lymphocyte in Preeclampsia

目的:探讨辅助性T淋巴细胞及协同刺激分子CD28/CTLA-4在子痫前期发病中的作用。方法:采集22例正常妊娠妇女(正常妊娠组)及45例子痫前期患者(子痫前期组,包括22例轻度和23例重度)外周血,用流式细胞技术分别检测外周血Th1、Th2及Th1/Th2比率及CD28和CTLA-4在CD4+T细胞的表达。结果:子痫前期组Th1、Th1/Th2、CTLA-4均高于正常妊娠组,且重度高于轻度(P<0.05);子痫前期组Th2、CD28/CTLA-4低于正常妊娠组,且重度低于轻度(P<0.05)。CD28与Th1呈负相关,r=-0.295;CTLA-4与Th1呈正相关,r=0.551,与Th2呈负相关,r=-0.363;CD28/CTLA-4与Th1/Th2呈负相关,r=-0.707。结论:子痫前期患者外周血协同刺激分子CD28/CTLA-4表达异常,高表达的CTLA-4促进CD4+T淋巴细胞过度活化并向Th1亚群分化,导致Th1/Th2比率失衡,这可能是子痫前期发生的重要原因之一。

Objective ：To investigate the expression and function of T-auxiliary lymphocyte and co-stimulatory molecule CD28/CTLA-4 in the pathogenesis of preeclampsia. Methods： Peripheral blood samples were collected from 22 healthy pregnant women （ healthy pregnant group）, and 45 patients with pre-eclampsia （pre-eclampsia group,including 22 mild PE and 23 severe PE）. Expressions of CD28CTLA-4 and Thl/Th2 in CD4 ＋T cells were determined by flow cytometry. Results：The Thl ,Thl/Th2 and CTLA-4 were higher in pre-eclampsia group than those in healthy pregnant group,and those in severe PE were higher than those in mild PE（ P〈0. 05）. The expression ratios of Th2 and CD28/CTLA-4 on CD4 ＋T lymphocyte decreased significantly in preeclampsia group compared to healthy pregnant group, and those in severe PE were lower than those in mild PE（ P 〈0.05）. The correlation of the CD28 and the Thl in CD4-positive lymphocytes was neg- ative correlated （ r = - 0.295 ）. The correlation of the CTLA-4 and the Thl was positive correlated （ r = 0. 551 ）. The correlation of the CTLA-4 and the Th2 was negative correlated（ r= -0. 363）. The correlation of the CD28/CTLA-4 and the ratio of Thl/Th2 was negative correlated （ r = - 0. 707）. Conclusions： The pre- eclampsia patients had an abnormal expression of CD28/CTLA-4 in CD4 ＋ T cells. The high exspession of CTLA-4 promote CD4 ＋T cell over-activation and differentiation to Thl, leading to the Thl/Th2 ratio imbal- ance,which might contribute to preeclampsia pathogenesis.