Graves病^(131)I或抗甲状腺药物治疗前后外周血CD4^+CD25^+CD127^(low)调节性T细胞的变化

Change of CD4^+ CD25^+ CD127^(low)regulatory T cells in peripheral blood of patients with Graves disease treated by ^(131)I or antithyroid drugs therapy

目的探讨调节性T细胞(Treg)在Graves病(GD)患者外周血中变化,以及^(131)I或抗甲状腺药物(ATD)治疗后其变化趋势,寻找评价^(131)I和ATD治疗疗效的新指标。方法健康者40例设为对照组,初诊GD患者40例设为GD组,并将GD组随机分成^(131)I治疗组(20例)及ATD治疗组(20例)。检测^(131)I治疗组、ATD治疗组治疗前、治疗后及对照组CD4^+CD25^+CD127^(low)Treg比例、白介素-10(IL-10)、转化生长因子-β1(TGF-β1)水平,通过统计学软件处理相关结果。结果①治疗前GD组Treg比例较对照组明显降低,差异有统计学意义(P<0.01);②^(131)I治疗组、ATD治疗组治疗后第3个月及第6个月Treg比例较治疗前均升高,差异均有统计学意义(P<0.01);③治疗后第3个月及第6个月,ATD治疗组Treg比例与^(131)I治疗组差异无统计学意义;④治疗前GD组IL-10、TGF-β1水平较对照组均降低,治疗后6个月,细胞因子水平较治疗前均升高,差异均有统计学意义(P<0.05),各时间点^(131)I治疗组与ATD治疗组之间,细胞因子差异无统计学意义。结论 GD患者Treg比例和功能显著降低,治疗后部分恢复,因此,对于甲亢患者,Treg可能是评价免疫状态及治疗后病情缓解的指标之一。

Objective To investigate the changes of regulatory T cells （Treg） in Graves disease （GD） before and after being treated by 131I or antithyroid drugs （ATD）, and to seek for new clinical indicators to evaluate the treat- ment response. Methods The study groups included 40 patients with GD （ GD group）, 20 of whom were treated by 131i , others were treated by ATD. Forty healthy donors without history of thyroid or autoimmune disease were en- rolled in control group. The proportions of CD4 ＋ CD25 ＋ CD127l^w Treg , IL-10 and TGF-~I were tested before and after treatment respectively. Results The significant decrease in the proportion of CD4 ＋ CD25 ＋ CD1271low WTreg cells in untreated GD patients （GD group） was found compared with the control group; After treatment of 131I or ATD, the proportion of Treg was significantly higher than GD group in 3rd and 6th month （ P 〈 0. 05 ） ; There was no significant difference in the proportion of Treg between ATD group and 1311 group in 3rd and 6th month; （~） The characteristic of cytokine levels（ such as IL-10 ,TGF-[31 ） was decreased in untreated GD group, and increased after being treated in 6th month （P 〈 0. 05, respectively）. There was no significant difference in the cytokine levels between the 131I group and ATD group at any moment . Conclusion The proportion and function of Treg decrease in GD, but increase in both 131I and ATD therapy patients. The study shows that Treg may play a critical role in af- fecting immunologic function and prognosis of GD patients.