检测不同活动期强直性脊柱炎患者Th1、Th2、Th17细胞的临床意义

Clinical significance of Th1,Th2 and Th17 cell determinations among different active stage ankylosing spondylitis patients

目的初步探讨辅助性T细胞1(Th1)、辅助性T细胞2(Th2)和辅助性T细胞17(Th17)在强直性脊柱炎(AS)发生、发展中的作用及临床意义。方法应用流式细胞术(FCM)及细胞内因子染色技术(ICS)检测78例AS患者(其中低活动性AS 44例、高活动性AS 34例)和30例健康体检者(正常对照组)外周血中Th1细胞、Th2细胞和Th17细胞数量,分析与AS活动性的相关性。结果 AS组、低活动性AS组和高活动性AS组外周血Th1细胞比例分别为15.86%±3.30%、14.18%±2.35%和17.75%±3.14%,均明显高于正常对照组(12.05%±2.35%,P<0.01),且高活动性AS组明显高于低活动性AS组(P<0.01)。AS组和高活动性AS组外周血Th2细胞比例分别为1.51%±0.51%、1.31%±0.41%,均明显低于低活动性AS组(1.90%±0.51%)和正常对照组(1.98%±0.60%)(P均<0.05)。AS组、低活动性AS组和高活动性AS组外周血Th17细胞比例分别为1.57%±0.78%、1.26%±0.57%和2.00%±0.86%,均明显高于正常对照组(0.82%±0.35%,P<0.05),且低活动性AS组明显低于高活动性AS组(P<0.01)。相关分析显示AS患者外周血Th1细胞、Th17细胞比例与Bath AS病情活动指数(BASDAI)呈正相关[相关系数(r)分别为0.809、0.409,P均<0.01],Th2细胞与BASDAI呈负相关(r=-0.340,P<0.01)。结论 AS患者CD4+T淋巴细胞亚群功能异常,由此导致的细胞因子网络失衡及体内免疫功能紊乱参与了AS的发生、发展。检测外周血Th1、Th2、Th17细胞数量有助于判断AS病情、提示预后。

Objective To investigate the roles and clinical significance of T helper cell 1 （Th1 ）,T helper cell 2 （Th2）and T helper cell 17（Th17）in the occurrence and development of ankylosing spondylitis （AS）.Methods A total of 78 AS patients（44 cases of low-activity group and 34 cases of high-activity group）and 30 healthy subjects （healthy control group）were enrolled,and their Th1,Th2 and Th17 percentages were determined by flow cytometry （FCM）and intracellular cytokine staining（ICS）technique.The relationship between the percentages of Th1 ,Th2 and Th17 and the activity of AS was analyzed.Results The percentages of Th1 in AS group,low-activity group and high-activity group were 15.86%±3.30%,14.18%±2.35%and 17.75%±3.14%,which were significantly higher than that in healthy control group （12.05% ±2.35%,P 〈0.01 ）.The percentage of Th1 in high-activity group was significantly higher than that in low-activity group（P〈0.01）.The percentages of Th2 in AS group and high-activity group were 1.51% ±0.51% and 1.31% ±0.41%,which were significantly lower than those in low-activity group （1.90%±0.51%）and healthy control group （1.98%±0.60%,P〈0.05）.The percentages of Th17 in AS group, low-activity group and high-activity group were 1.57%±0.78%,1.26%±0.57% and 2.00%±0.86%,which were significantly higher than that in healthy control group （0.82%±0.35%,P〈0.05 ）.The percentage of Th17 in low-activity group was significantly lower than that in high-activity group （P〈0.01 ）.The relationship between Bath AS disease activity index （BASDAI）and the percentages of Th1 and Th17 showed that there was a positive correlation＆nbsp;[correlation coefficient （r）0.809 and 0.409,P〈0.01 ],and BASDAI with the percentage of Th2 had negative correlation （r = -0.340,P 〈0.01 ）.Conclusions AS patients′CD4 ＋ T lymphocyte subsets are functionally defective,consequent to the imbalance of cytokine network and immune functional defection,being involved in occurrence and development.Th1,Th2 and Th17 can be as new detection indices for the diagnosis of AS,which could serve as indicators of prognosis.