退白颗粒联合NB-UVB对白癜风患者外周血T细胞亚群的影响

Effects of NBUVB Combined with Tuibai Granule on CD4^+/CD8^+ Tlymphocyte Ratio and CD4^+CD25^+ Treg in the Peripheral Blood of Vitiligo Patients

目的检测白癜风患者外周血CD4^+、CD8^+T细胞及CD4^+CD25^+调节性T细胞(Treg)的水平,同时对退白颗粒联合NB-UVB治疗后两者的水平进行检测,探讨两者与该病的关系。方法采用流式细胞仪对120例白癜风患者及30例健康对照组外周血CD4^+、CD8^+T细胞及CD4^+CD25^+Treg细胞水平进行检测,同时120例患者分为3组,各40例。联合治疗组采用退白颗粒联合NB-UVB治疗、对照Ⅰ组采用单独NB-UVB治疗,对照Ⅱ组采用退白颗粒治疗,疗程为3月,对3组患者治疗前后CD4^+/CD8^+比值及CD4^+CD25^+Treg水平与健康对照组进行比较。结果白癜风患者外周血CD4^+T淋巴细胞明显降低,而CD8^+T淋巴细胞则明显升高,与健康对照组比较均有统计学差异(P<0.01);进展期患者CD4^+/CD8^+比值明显低于稳定期(P<0.01),稳定期与健康对照组比较无统计学差异(P>0.05);白癜风患者CD4^+CD25^+Treg细胞百分率明显低于健康对照组(P<0.01),且进展期患者CD4^+CD25^+Treg细胞比稳定期下降更明显(P<0.01)。采用退白颗粒联合NB-UVB治疗后CD4^+/CD8^+比值及CD4^+CD25^+Treg明显上调,与单独NB-UVB和单独退白颗粒治疗比较,差异有显著性意义(P<0.01或P<0.05)。结论 CD4^+/CD8^+比值的失衡与CD4^+CD25^+Treg数量的异常可能参与了白癜风的发病,退白颗粒联合NB-UVB可能通过调节两者的水平对该病发挥治疗作用。

OBJECTIVE To detect the expression levels of CD4^＋, CD8^＋ Tlymphocytes and CD4^＋ CD25^＋ Treg in the peripheral blood of patients with vitiligo after the treatment of NBUVB combined with Tuibai Granule, and then explore the relationship between vitiligo pathogenesis and the levels of CD4^＋ , CD8^＋ Tlymphocytes as well as CD4^＋ CD25^＋ Treg. METHODS The expression levels of CD4^＋ , CD8^＋ Tlymphocytes and CD4^＋ CD25^＋ Treg were detected by FlowCytometry among 120 cases of vitiligo patients and 30 cases of healthy control group. Then the 120 cases were further divided into three groups, with 40 cases in each group. Patients in the treatment group were treated with NBUVB combined with Tuibai Granule; Patients in the control group Ⅰ were only given NBUVB, while those in the control group Ⅱ only took Tuibai Granule. After 3 months treatment, the changes of the CD4^＋/CD8^＋ ratio and the expression levels of CD4^＋ CD25^＋ Treg were once again tested and the comparison was made among the four groups. RESULTS The CD4^＋ Tlymphocytes level in the peripheral blood decreased significantly, while the CD8^＋ Tlymphocytes level increased evidently. There were significant statistical differences when compared with the healthy control group（P〈0.01）; The CD4^＋/CD8^＋ ratio of the progressive stage was much lower than that of the stable stage（P〈0.01） ; the CD4^＋/CD8^＋ ratio of the stable stage had no statistical difference when compared to that of the healthy control group（P〉0.05）. The frequency of CD4^＋ , CD25^＋ Treg of vitiligo patients was significantly lower than that of healthy control group（P〈0.01）, and the frequency of CD4^＋ , CD25^＋ Treg of the progressive stage was also lower than that of the stable stage（P〈0.01）. After treatment with NBUVB combined with Tuibai Granule, the CD4^＋/CD8^＋ ratio and the frequency of CD4^＋ , CD25^＋ Treg were significantly up-regulated compared with either the control group I or the control group Ⅱ （P〈0.01, P〈0.05）. CONCLUSION These findings suggest that the abnormal level of CD4^＋/CD8^＋ ratio and the frequency of CD4^＋ , CD25^＋ Treg might be involved in the vitiligo pathogenesis. NBUVB combined with Tuibai Granule can prevent vitiligo by regulating the CD4^＋/CD8^＋ ratio and the frequency of CD4^＋ , CD25^＋ Treg.