慢性阻塞性肺病急性加重期患者外周血树突状细胞数量变化的研究

Fluctuation and Its Significance of Dendritic Cell Subsets in Peripheral Blood in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的 检测慢性阻塞性肺病急性加重期（AECOPD）患者外周血树突状细胞（DCs）亚型水平变化,探索DCs与AECOPD的相关性,讨论DCs在AECOPD中的可能作用机制.方法 采用流式细胞术分别检测43例AECOPD患者,24例稳定期COPD患者以及19名健康对照组外周血DCs亚群（mDC1,mDC2,pDC）比例,同时检测各组外周血T淋巴细胞亚群（CD3、CD4、CD8、总活化T淋巴细胞、静止T淋巴细胞）、NK、NKT水平;比较各组外周血DCs水平、T淋巴细胞水平及临床指标的差异及相关性.结果 1.与健康对照组相比,AECOPD患者外周血mDC1、pDC百分比及绝对值显著升高（P〈0.001）.mDC2绝对值也显著升高（P〈0.01）,而两组间mDC2的百分比差异无统计学意义（P〉0.05）.与稳定期相比,AECOPD组mDC1比例（P〈0.01）及绝对值均升高（P〈0.001）,pDC绝对值升高（P〈0.01）.且mDC1绝对值与CRP（r=0.315,P=0.003）及中性粒细胞百分比（r=0.39,P=0.000）呈正相关.2.与健康对照组相比,AECOPD组NKT（P〈0.001）及总活化T淋巴细胞水平（P〈0.001）显著升高.与稳定期组相比上述指标差异无统计学意义（P〉0.05）.结论 AECOPD患者外周血DCs水平上升并与CRP、中性粒细胞百分比正相关,NKT及总活化T细胞水平上升,提示AECOPD患者免疫炎症反应加剧,DCs可能参与了疾病的发生发展.

Objective To detect the fluctuation of dendritic cell （DCs） subsets in peripheral blood in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）, and to explore the correlation between DCs and AECOPD and discuss the possible mechanism of DCs in AECOPD. Methods 43 patients with AECOPD, 24 patients with stable COPD and 19 normal healthy controls were enrolled in the study. Frequency of circulating DC subsets （mDC1, mDC2, pDC） and lymphocyte subsets （CD3, CD4, CD8, total activation T lymphocytes, stationary T lymphocytes）, NK, NKT level were assessed by multiparametric flow cytometry in all groups. The differences and correlation between the levels of DCs and T lymphocytes and clinical characteristics were compared. Results 1.Compared with the healthy control group, the percentage and absolute value of mDC 1, pDC in patients with AECOPD were significantly increased （P 〈 0.001）, and the absolute value of mDC2 was also significantly increased （P 〈 0.01）, while there was no significant difference between the percentage of mDC2 in two groups （P 〉 0.05）. Compared with the stabilization period, the proportion （P 〈 0.01） and absolute value （P 〈 0.001） of mDC1 in AECOPD group increased significantly, the absolute value of pDC was significantly increased （P 〈 0.01）. And the absolute number of mDC1 was positively correlated with CRP （r=0.315, P= 0.003） and the percentage of neutrophils （r=0.39, P=0.000）. 2.Compared with the healthy control group, NKT （P 〈 0.001） and total activated T lymphocyte （P 〈 0.001） level were significantly increased in AECOPD group. There was no significant difference in the above indicators compared with the stabilization group （P 〉 0.05）. Conclusion The level of DCs in peripheral blood of AECOPD patients were increased and the absolute number of mDC1 was positively correlated with CRP and the percentage of neutrophils. The level of NKT and total activated T cells were also increased significantly which indicates that the immune inflammatory response of patients with AECOPD is increased. And DCs may be involved in the development of the disease.