Th1/Th2失衡在初发系统性红斑狼疮患者中的研究

Imbalance of Th1 /Th2 in recent-onset systemic lupus erythematosus patients

目的 利用三荧光标记法流式细胞术检测细胞内细胞因子 ,从单细胞水平研究初发系统性红斑狼疮 (SLE)患者Th1/Th2平衡。方法 全血培养后使用荧光标记的抗细胞表面抗原单抗标记表面抗原 ,抗细胞因子单抗进行细胞内染色 ,检测出CD4 + 干扰素 (IFN) γ+ 白细胞介素 (IL) 4 -及CD4 + IFN γ-IL 4 + 细胞作为Th1及Th2细胞 ,从单细胞水平研究初发SLE患者Th1/Th2平衡。结果 未用药治疗的SLE病人其Th1细胞明显低于正常对照组 (P =0 0 2 )。 35例SLE患者按Th1/Th2可分成两组 ,Th1/Th2降低组与Th1/Th2升高组。Th1/Th2降低组其Th1细胞的降低十分明显。Th1/Th2升高组中Th1细胞仅轻度下降。Th1/Th2降低组体现了更高的颊部红斑发生率(P =0 0 36 )。结论 Th1型反应与Th2型反应均参与了SLE的发病。不同患者可能免疫系统的异常并不同。Th1细胞的降低可能与颊部红斑发生有关。

Objective To detect intracellular cytokines of systemic lupus erythematosus (SLE) patients untreated with glucocorticoids and immunosuppressive agents using three color flow cytometry.Methods Whole blood were cultured and stained with Cy conjugated anti surface antigen monoclonal antibody (mAb).Then fixation and permeabilization method were used to perform intracellular cytokin staining with FITC conjugated IFN γ specific mAb and PE conjugated IL 4 specific mAb.The percentage of IFN γ and IL 4 positive cells was counted by FACS,and the Th1/Th2 balance was evaluated by the ratio of IFN γ to IL 4.Results The percentage of Th1 type cells in untreated SLE patients was significantly lower than that in healthy controls ( P =0.02).Patients were divided into two groups:one with high Th1/Th2 ratio and another with low Th1/Th2 ratio.Patients with high Th1/Th2 ratio had more frequent malar rash ( P =0 036).Conclusion The results indicate that both Th1 and Th2 responses play prominent roles in the pathogenesis of lupus.The decrease of Th1 cells may relate to malar rash.