AIHA患者外周血Tfh/Treg细胞的检测及临床意义

Detection of Tfh/Treg Subsets on Peripheral Blood of the Patients with Autoimmune Haemolytic Anaemia

目的研究自身免疫性溶血性贫血（AIHA）患者外周血CD4＋CXCR5＋T细胞（Tfh）及CD4＋CD25＋FoxP3＋ T细胞（Treg）数量和比例及相关细胞因子的变化，探讨其在AIHA发病机制中的作用。方法选择30例AIHA患者，分离外周血单核细胞（PBMC），采用流式细胞术（FCM）检测Tfh及Treg细胞的数量，ELISA法测定血清中IL-21，IL-10的水平及IL-21／IL-10比值变化，与同期选择的健康对照组比较。结果AIHA患者PBMC中Tfh细胞及IL-21因子的水平均高于健康对照组，而Treg细胞及IL-10水平低于对照组，差异均有统计学意义（P〈0．05），Tfh／Treg与IL-21／IL-10比值均升高（P〈0．05），且IL-21／IL-10比值变化与患者病情呈正相关（P〈0．05）。结论Tfh及Treg细胞的比例异常及相关细胞因子IL-21／IL，10比值变化可能参与AIHA患者的免疫紊乱机制。

Objective To determine the peripheral blood Tfh cell and Treg subsets in patients with Autoimmune Haemolytic Anaemia （AIHA） and explore their significances. Methods The CD4＋ CXCR5＋ T（Tfh）, CD4＋ CD25＋ FoxP3＋ T（Treg） subsets of the peripheral blood from 30 patients with AIHA and 30 healthy controls were analyzed by flow cytometry with immunofluorescent staining. The levels of the peripheral blood IL 21 and IL-10 were detected by ELISA assays. Results The numbers of peripheral blood Tfh and the levels of IL-21 were significantly increased in patients with AIHA in comparison with those of healthy controls （P〈0.05）, but the Treg subsets and IL-10 levels were lower than those of controls. The ratios of the Tfh/Treg and the IL-21/IL-10 were higher those of controls, they had significantly difference（P〈0.05）. Besides,there were positive relation between the ratio of IL-21/IL-10 and the AIHA disease conditions. Conclusion The predominance of Tfh in peripheral blood of AIHA and the lower Treg levels may play an important role in the pathogenesis of AIHA.