类风湿关节炎患者CD4^+CXCR5^+Tfh细胞水平的检测及临床意义

The Detection and Clinical Significance of Peripheral Blood CD4^+CXCR5^+ Tfh Cells in 30 Patients with Rheumatoid Arthritis

目的检测类风湿关节炎(RA)患者血清趋化因子受体CXCR5(CXCR5)在外周血滤泡辅助性T细胞(Tfh cells)上的表达水平,分析CD4^+CXCR5^+Tfh细胞在类风湿关节炎中的临床意义。方法收集30例类风湿关节炎(RA)患者和30例健康对照(HC)的临床资料,采用流式细胞术检测外周血CD4^+CXCR5^+Tfh细胞水平,探讨其与实验室指标及疾病活动性与影像学改变的相关性。结果 (1)与HC相比,RA患者外周血CD4^+CXCR5^+Tfh细胞水平显著升高(P<0.05)。(2)高中疾病活动组RA患者外周血CD4^+CXCR5^+Tfh细胞水平明显高于低疾病活动及缓解期组和健康对照组(P<0.05)。(3)无关节骨侵蚀RA患者外周血CD4^+CXCR5^+Tfh细胞水平与血沉(ESR),健康评估问卷(HAQ),肿胀关节数,晨僵时间正相关(P<0.05)。结论 RA患者外周血Tfh细胞水平显著升高,且Tfh细胞主要在疾病高度活动时参与免疫反应。此外,本研究发现了外周血CD4^+CXCR5^+Tfh细胞可能在RA疾病早期,即尚未发生关节骨侵蚀阶段的病情进展中发挥了重要作用,提示及时阻断该炎症因子,有可能阻止RA骨破坏的发生。

Objective This study aims to detect the expression of serum C-X-C chemokine receptor type 5（CXCR5）in peripheral blood follicular helper T（Tfh）cells of rheumatoid arthritis（RA）patients and analyze the clinical significance of CD4＋CXCR5＋Tfh cells in RA.Methods The study collected the clinical data of 30 RA patients and 30 healthy controls（HC）.The levels of CD4＋CXCR5＋Tfh cells in peripheral blood were determined by flow cytometry,and the correlations between CD4＋CXCR5＋Tfh cells and laboratory parameters,disease activity and imaging changes were discussed.Results The levels of CD4＋CXCR5＋Tfh cells in peripheral blood of RA patients were significantly higher than that in HC（P〈0.05）.Besides,the levels of CD4＋CXCR5＋Tfh cells in the RA patients with high or moderate disease activities were significantly higher than that of RA patients with low disease activity or remission and HC（P〈0.05）.Furthermore,the peripheral blood CD4＋CXCR5＋Tfh cells levels were positively correlated with erythrocyte sedimentation rate（ESR）,health assessment questionnaire（HAQ）,number of swollen joints and morning stiffness time in RA patients without joint bone erosion（P〈0.05）.Conclusion This study found that the peripheral Tfh cell levels were higher in RA patients than HC,and the Tfh cells were mainly involved in the immune response when the disease was in highly active.Moreover,our data discovered that the peripheral blood CD4＋CXCR5＋Tfh cells play an important role in the early stage of RA,which is in the progression of RA without joint bone erosion.blocking this inflammatory factor in time may prevent the bone erosion of RA.