强直性脊柱炎患者外周血CD4^-CD8^-双阴性T细胞的检测及意义

THE SIGNIFICANCE OF DOUBLE NEGATIVE T CELLS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

目的通过检测CD4-CD8-双阴性(DN)T细胞在强直性脊柱炎(AS)外周血中的表达水平,探讨DNT细胞与AS发病机制的关系以及在AS诊断治疗中的临床应用价值。方法采用流式细胞技术检测30例未经治疗的活动期AS患者及30例健康对照人群外周血中的CD4^+T细胞亚群、CD8^+T细胞亚群、DNT细胞的表达水平,并探讨DNT与Bath AS功能指数(BASFI)、Bath AS测量指数(BASMI)、病程、年龄及实验室炎性指标血沉(ESR)、超敏C反应蛋白(hs-CRP)的相关性。结果 AS患者DNT细胞水平为(8.62±3.09)%较正常对照组的(5.47±2.78)%明显升高(P<0.001),CD4^+T细胞亚群和CD4^+/CD8^+比值分别为(29.24±9.22)%和(0.96±0.49)较正常对照组的(40.09±6.86)%和(1.70±0.67)显著降低(P<0.001),CD8^+T细胞亚群水平为(32.91±6.86)%较正常对照组的(25.60±5.97)%明显增高(P<0.001),AS患者外周血DNT细胞水平与CD4^+呈负相关,r=-0.497(P<0.01),和CD4^+/CD8^+呈负相关,r=-0.520(P<0.01),与CD8^+呈正相关,r=0.371(P<0.05),与hs-CRP呈正相关,r=0.439(P<0.05),与BASMI呈正相关,r=0.729(P<0.001),与BASFI呈正相关,r=0.636(P<0.001),与AS患者的年龄、病程、ESR均无明显相关性。结论 AS患者外周血DNT细胞水平明显升高,并与AS疾病活动存在相关性,检测DNT细胞有助于研究AS的发病机制,并有助于早期发现病情活动,为判断病情和制定治疗策略提供更好的依据。

Objective To explore the relationship between the DNT cells and AS patients,and to explore its value in the clinical application by detecting the level in double negative T cells.Methods Quantify CD4^＋T cells,CD8^＋T cells and DNT cells in the peripheral blood of 30 patients in active stage of AS and 30 healthy controls were detected by flow cytometry,and the correlations of DNT cells with BASFI,BASMI,the duration of disease,age,ESR,hs-CRP were analyzed.Results Compared with DNT cells in peripheral bloods of the control group（5.47±2.78）%,DNT cells of AS patients（8.62±3.09）% were increased significantly（P〈0.001）.The percentage of CD4^＋T cells and CD4^＋/CD8^＋in the peripheral blood of AS patients was lower than healthy controls（P〈0.001）.The percentage of CD8^＋cells（32.91±6.86）%in the peripheral blood of AS patients was higher than healthy controls（25.60±5.97）%（P〈0.001）.The percentage of DNT cells was negatively correlated with CD4^＋T cells（r=-0.497,P〈0.01）and CD4^＋/CD8^＋（r=-0.520,P〈0.01）,while the percentage of DNT cells was positively correlated with CD8^＋cells（r=0.371,P〈0.05）,hs-CRP（r=0.439,P〈0.05）,BASMI（r=0.729,P〈0.001）and BASFI（r=0.636,P〈0.001）,However,there was no significant difference between DNT cells and the duration of disease,age,ESR.Conclusions Our data suggest that the abnomal expression of DNT cells correlate with AS patients significantly,the expression of DNT is found to be correlated with disease activity.DNT cells might play a important role in the pathogenesis of AS and it can be hopefully used in the treatment of AS patients.