Graves病患者外周血T细胞亚群和共刺激分子的表达及其意义

Significance of T Cell Subsets and Expression of Costimulatory Molecule in Peripheral Blood of Patients with Graves' Disease and its Implication on Clinical Outcome

为研究Graves病患者外周血T细胞亚群及共刺激分子的表达 ,并探讨其在Graves免疫病理机制中的作用 ,本文采用免疫荧光标记和流式细胞仪术检测了 19例Graves病患者和 11例正常人外周血T细胞亚群及共刺激分子 (CD2 8、B7、CD40、CD40L、 4 1BB、OX40 )的表达。结果表明 ,19例初诊Graves病患者外周血T细胞亚群呈现异常改变 ,表现为CD3+ 和CD4+T细胞显著下降 (P <0 0 5 ,P <0 0 1) ,CD4+ /CD8+ T细胞比值倒置 (P <0 0 1) ,共刺激分子CD2 8在T细胞中的表达水平明显下降 (P <0 0 1) ,T细胞亚群CD4+ CD2 8+ 、CD8+ CD2 8+ 细胞数量均减少 (P <0 0 5 ,P <0 0 1) ,而 4 1BB分子表达显著地升高 (P <0 0 5 )。随防 10例治疗后缓解患者 ,T细胞亚群失衡明显改善 ,共刺激分子CD2 8的表达水平上调 (P <0 0 1) ,而4 1BB分子的表达明显下降 (P <0 0 1) ,T细胞亚群CD4+ CD2 8+ 、CD8+ CD2 8+ 细胞数量均增加 (P <0 0 1) ,甲状腺自身抗体甲状腺球蛋白抗体 (TGAb )和甲状腺微粒体抗体 (TMAb )的表达水平均下降 (P <0 0 1,P <0 0 1)。从而表明 ,T细胞亚群的异常及共刺激分子CD2 8、 4 1BB的表达改变与Graves病的免疫病理机制相关。

To investigate T cell subsets and the expression of costimulatory molecule in peripheral blood mononuclear cells(PBMC) of patients with Graves' disease(GD) and its role on pathogenesis of GD,the T cell subsets and expression of costimulatory molecule in 19 GD patients were analyzed by using immunophenotyping and flowcytometry. The experimental results showed that CD3 + and CD4 + T cells decreased significantly(P<0.05) and the ratio of CD4 +/CD8 +T cell was reversed in active GD patients;the expression of CD28 on T cells was remarkably lower compared to that of normal controls(P<0.01);both CD4 +CD28 +?CD8 +CD28 + T cells in PBMC reduced significantly(P<0.05,P<0.01) while the high expression of 4-1BB was presented than those in controls(P<0.05). After effective treatment,T cell subsets and the expression of CD28 and 4-1BB tended to return to normal(P<0.01) and CD4 +CD28 +?CD8 +CD28 + T cells increased(P<0.01). Thyroid autoantibody,such as TGAb and TMAb,also decreased correlatively(P<0.01,P<0.01). It concludes that abnormal T cell subsets and CD28 and 4-1BB costimulatory molecule play an important role in pathogenesis and development of GD.