可诱导共刺激分子/可诱导共刺激分子配体在视神经脊髓炎谱系疾病患者外周血中的表达意义

Expressive meaning of the inducible co-stimulator molecule/inducible co-stimulator ligand in the peripheral blood of neuromyelitis optica spectrum disorder patients

目的 检测视神经脊髓炎谱系疾病（NMOSD）患者外周血中T细胞可诱导共刺激分子（ICOS）的表达情况,并探讨其临床意义.方法 分别收集2015年4月至2016年4月就诊于苏州大学附属第一医院的13例NMOSD患者、13例长节段/横贯性脊髓炎（LETM）患者、13例视神经炎患者（发病早期）及16名健康成年人的外周血标本,采用流式细胞术检测外周血单个核细胞膜表面ICOS及可诱导共刺激分子配体（ICOSL）的表达情况,同时收集3组患者及健康对照组血清,应用酶联免疫吸附法检测4组血清可溶性ICOS （sICOS）含量并进行统计学分析.结果 NMOSD发病早期患者外周血T淋巴细胞表面ICOS表达（26.37％±3.48％）明显高于健康对照组（0.95％±0.32％,t=7.31,P＜0.01）及另外两组患者（LETM 8.04％±2.14％,视神经炎10.51％ ±2.05％,t =4.50、3.93,均P＜0.01）,而血清中sICOS表达[（10.65±2.86） pg/ml]则明显低于健康对照组[（22.69±4.14） pg/ml,=3.39,P＜0.01]及另两组患者[LETM （29.31±8.52） pg/ml,视神经炎（21.71±4.14） pg/ml,t=2.82、3.13,均P＜0.01],差异具有统计学意义.结论 ICOS/ICOSL通路在NMOSD病理过程较早阶段发挥作用,是免疫应答的一个重要途径.

Objective To observe and discuss the clinical significance of the expression of inducible co-stimulator molecule （ICOS） induced by T-cell in peripheral blood of neuromyelitis optica spectrum disorder （NMOSD） patients.Methods Flow cytometry was applied to detect the expression of ICOS on peripheral blood mononuclear cells from the peripheral blood of 13 NMOSD patients,13 longitudinally extensive transverse myelitis （LETM） patients,13 optic neuritis （ON） patients and 16 healthy controls in the First Affiliated Hospital of Suzhou University from April 2015 to April 2016.Enzymelinked immunosorbent assay was performed to analyze the levels of soluble ICOS in plasma samples from NMOSD,LETM,ON patients and healthy controls.Results The level of ICOS from the peripheral blood of NMOSD patients （26.37% ±3.48%）was significantly higher than that from LETM （8.04% ±2.14%,t =4.50,P〈0.01）,ON patients （10.51% ±2.05%,t =3.93,P〈0.01） and healthy controls （0.95% ± 0.32%,t =7.31,P 〈 0.01）.However,the level of soluble ICOS from NMOSD patients （（10.65 ± 2.86） pg/ml） was lower than that from the other 3 groups （LETM （29.31 ± 8.52） pg/ml,t =2.82,P 〈 0.01;ON （21.71 ±4.14） pg/ml,t=3.13,P〈0.01;healthy controls（22.69 ±4.14） pg/ml,t =3.39,P〈 0.01）.Conclusion The ICOS/ICOS ligand pathway takes part in the earlier stage of the NMOSD pathological process,and it is essential in immune response.