程序性死亡受体1/程序性死亡配体1信号各组分在急性冠脉综合征患者外周血中的表达及意义

Expression of programmed death-1/programmed death-L1 in peripheral blood from patients with acute coronary syndrome and it＇s significance

目的 探讨程序性死亡受体1/程序性死亡配体1信号各组分在急性冠脉综合征（ACS）患者外周血中的表达及意义.方法 采用流式细胞术检测CD4^＋ CD28^-T细胞表面程序性死亡受体1（PD-1）以及单核细胞表面程序性死亡配体1（PD-L1）的表达;采用酶联免疫吸附实验（ELISA）检测外周血中可溶性程序性死亡受体1（sPD-1）,可溶性程序性死亡配体1（sPD-L1）和干扰素-γ（IFN-γ）的浓度.结果 与稳定性心绞痛（SA）和正常对照组（HC）相比,ACS患者CD4^＋ CD28^-T细胞表面PD-1和单核细胞表面PD-L1的表达明显上调（P＜0.05）,外周血中sPD-1、sPD-L1和IFN-γ的水平显著升高（P＜0.05）.其中,sPD-L1和IFN-γ的水平呈显著正相关（r=0.772,P＜0.05）.sPD-1和IFN-γ的水平无相关性（r =0.306,P＜0.05）.结论 ACS患者体内CD4＋ CD28-T细胞过量产生的IFN-γ是单核细胞表面PD-L1表达上调和外周血sPD-L1水平升高的原因之一,为进一步研究CD4^＋ CD28^-T细胞的增殖活化和防治ACS提供理论依据.

Objective To investigate the expression of programmed death-1 （PD-1）/ programmed death-1 ligand-1 （PD-L1） in peripheral blood from patients with acute coronary syndrome（ACS） and it＇s significance.Method The expression of membrane-bound PD-1 on CD4 ＋ CD28-T cells and PD-L1 on monocytes was examined by flow cytometry.The serum levels of souble programmed death-1 （sPD-1）,souble programmed death-1 ligand-1 （sPD-L1） and interferon-γ（IFN-γ） were analyzed by ELISA.The percentage of CD4^ ＋ CD28^-T cell was determined by flow cytometry.The level of IFN-γ in culture supematants was detected by ELISA.Results The expression of PD-1 on CD4 ^＋ CD28^-T cells and the expression of PD-L1 on monocytes from patients with ACS were significantly higher than those from patients with stable angina （SA） and health controls （HC） （P 〈 0.05）.The serum levels of sPD-1,sPD-L1 and IFN-γ in patients with ACS were also elevated markedly compared to patients with SA and HC （P 〈0.05）.The serum level of sPD-L1 （r =0.772,P 〈 0.001） not PD-1 （r =0.306,P =0.055） was closely correlated with that of IFN-γ.Contusion In patients with ACS,increased PD-L1 and sPD-L1 resudt from over-producing of IFN-γfrom CD4^＋ CD28^-T cells,this study will offer theoretical basis in order to investigate the proliferation and activation of CD4 ^＋ CD28^-T cells and ACS.