甲泼尼龙冲击治疗对视神经脊髓炎谱系病患者外周血滤泡辅助性T细胞百分率的影响

Methylprednisolone Inhibited Cinculating T Follicular Helper Cell in Neuromyelitis Optica Spectrum Disorder

目的探究视神经脊髓炎谱系病(NMOSD)患者外周血滤泡辅助性T细胞(Tfh)百分率在甲泼尼龙冲击治疗前、后的变化。方法收集AQP-4抗体阳性的急性期NMOSD患者(NMOSD组)23例,采用流式细胞术检测甲泼尼龙冲击前、后外周血CXCR5^+ICOS^+的CD4^+T细胞(Tfh细胞),记录NMOSD组的EDSS评分,分析NMOSD组患者Tfh细胞百分率与患者AQP-4抗体滴度及EDSS评分的相关性。结果 NMOSD组患者甲泼尼龙冲击治疗前外周血Tfh细胞百分率[(1.77±0.74)%]显著高于甲泼尼龙冲击治疗后[(1.26±0.45)%](t=2.284,P=0.032)。首次发病NMOSD患者甲泼尼龙冲击治疗前Tfh细胞百分率与EDSS评分呈正相关(r=0.625,P=0.040),甲泼尼龙冲击治疗前、后Tfh细胞百分率与AQP-4抗体滴度无相关性(r=--0.02,P=0.928)。结论经甲泼尼龙冲击治疗后,NMOSD患者急性期外周血Tfh细胞百分率降低,首次发病NMOSD患者Tfh细胞百分率水平与EDSS评分有关。Tfh细胞百分率水平可能与NMOSD的复发有关。

Aim To explore the effects of methylprednisolone on circulating T follicular helper （Tfh） cells in patients with neuromyelitisoptica spectrum disorder （NMOSD）. Methods Circulating blood from 23 AQP4-Ab positive NMOSD patients （NMOSD group） were collected to assess proportions of circulating CD4^＋CXCR5^＋ICOS^＋ （Tfh） cells in CD4^＋T cells by flow cytometry. Twenty-three NMOSD patients had their blood redrawn within 20 days after receiving methylprednisolone pulse treatment. Disease activity was evaluated by Expaned Disability Status Scale （EDSS）. Results The proportion of circulating Tfh cells in patients before methylprednisolone treatment was significantly higher than that in NMOSD patients after methylprednisolone treatment （t=2.284, P=-0.032）. The proportion of circulating Tfh cells in new-onset NMOSD patients was correlated with EDSS （r=0.625, P=0.040）. No correlation between AQP4-Ab titer and Tfh cell proportions was found （r=-0.02, P=0.928）. Conclusion Methylprednisolone treatment down-regulated circulating Tfla cell proportions in vivo. The proportion of circulating Tfla cells in new-onset NMOSD patients were correlated with EDSS. Increased circulating Tfh cell proportions in NMOSD patients might contribute to the pathogenesis of NMOSD.