CD19^＋CD24^ hi CD27^ hi调节性 B 细胞预测急性胰腺炎严重程度的作用研究

The role of CD19^＋CD24^hiCD27^hi regulatory B cells in the severity assessment of acute pancreatitis

目的：探讨调节性B细胞（ regulatory B cells ， Bregs ）在急性胰腺炎发病机制中的作用。方法流式细胞仪检测急性胰腺炎患者（其中轻型胰腺炎36例，重症胰腺炎15例）外周血CD19^＋IL-10^＋、CD19^＋CD24^hiCD27^hi Bregs 比例及CD19^＋CD24^hi CD27^hi Bregs 表面共刺激分子CD80和CD86，并与淋巴细胞数、C反应蛋白（CRP）作相关性分析。结果重症胰腺炎、轻型胰腺炎患者外周血中淋巴细胞数、CD19^＋淋巴细胞数、CD19^＋IL-10^＋、CD19^＋CD24^hi CD27^hi Bregs及CD19^＋CD24^hi CD27^hi Bregs细胞表面CD80、CD86平均荧光强度均明显低于正常对照组，重症胰腺炎组淋巴细胞数、CD19^＋淋巴细胞数、CD19^＋IL-10^＋绝对数、CD19^＋CD24^hiCD27^hi Bregs绝对数及CD19^＋CD24^hiCD27^hi Bregs细胞表面CD80和CD86平均荧光强度低于轻型胰腺炎组。动态观察结果显示，随着疾病的进展，轻型胰腺炎组CD19^＋IL-10^＋、CD19^＋CD24^hiCD27^hi Bregs均先降低后明显升高；而重症胰腺炎组CD19^＋IL-10^＋、CD19^＋CD24^hiCD27^hi Bregs却持续降低。相关性分析显示，CD19^＋IL-10^＋与CD19^＋CD24^hiCD27^hi Bregs， CD19^＋淋巴细胞数成明显正相关，而与CRP 成明显负相关。结论 CD19^＋IL-10^＋与 CD19^＋CD24 hi CD27^hi Bregs细胞数量及功能异常可能是导致急性胰腺炎患者免疫功能紊乱的重要原因之一。

Objective To investigate the prognostic value of regulatory B cells （Bregs） in patients with acute pancreatitis .Methods Flow cytometry analysis was performed to detected the percentages of CD19^＋IL-10^＋and CD19^＋CD24^hiCD27^hi Bregs in peripheral blood samples collected from patients with acute pancreatitis （36 cases with mild acute pancreatitis and 15 cases with severe acute pancreatitis ） as well as the surface costimulatory molecules including CD80 and CD86 on CD19^＋CD24^hiCD27^hi Bregs.Their correlations with lymphocytes and C-reactive protein （ CRP） were further analyzed .Results The numbers of lympho-cytes, CD19^＋lymphocytes, CD19^＋IL-10^＋and CD19^＋CD24^hi CD27^hi Bregs in peripheral blood samples col-lected from patients with severe and mild acute pancreatitis as well as the mean fluorescence intensities （ MFI） of CD80 and CD86 were significantly lower than those from healthy subjects .Compared with patients with mild acute pancreatitis , the numbers of lymphocytes and CD19^＋lymphocytes , the absolute numbers of CD19^＋IL-10^＋and CD19^＋CD24^hiCD27^hi Bregs as well as the mean fluorescence intensities （MFI） of CD80 and CD86 in patients with severe acute pancreatitis were significantly decreased .The percentages of CD19^＋IL-10^＋and CD19^＋CD24^hiCD27^hi Bregs in patients with mild acute pancreatitis were significantly increased af-ter an initial drop , but in patients with severe acute pancreatitis those values were continuously decreased along with the disease progression .The percentage of CD19^＋IL-10^＋Bregs was positively correlated with the percentage of CD19^＋CD24^hiCD27^hi Bregs and the absolute number of CD19^＋lymphocytes, but was negatively correlated with CRP .Conclusion The abnormal number and function of CD19^＋IL-10^＋and CD19^＋CD24 hi CD27^hi Bregs might be one of the important reasons causing immune dysfunction in patients with acute pan -creatitis.