补肾益髓胶囊对缓解期视神经脊髓炎谱系疾病滤泡辅助性T细胞的影响

Effects of Bushen Yisui capsules on follicular helper T cells in the remission of neuromyelitis optica spectrum disorders

目的观察补肾益髓胶囊对视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSD)患者外周血中滤泡辅助性T细胞(T follicular helper cells,Tfh)及白介素(interleukin,IL) 6、IL-21、干扰素(interferon,IFN)γ、趋化因子(C-X-C motif ligand,CXCL) 13细胞因子表达水平的影响,探讨补肾益髓胶囊治疗NMOSD的作用机制。方法纳入缓解期NMOSD患者25例,对其进行补肾益髓胶囊干预3个月。利用流式细胞计数检测NMOSD患者经补肾益髓胶囊治疗前后外周血中CD4+PD1+CXCR5+Tfh亚群的分布变化情况,应用蛋白芯片技术检测NMOSD患者外周血中IL-6、IFN-γ、CXCL13及IL-21细胞因子的表达水平。结果 NMOSD缓解期患者经补肾益髓胶囊治疗3个月后,扩展残疾状态量表(expanded disability status scale,EDSS)评分及中医症状评分显著降低(P <0. 05或P <0. 01);外周血Tfh亚群分布较治疗前明显降低(P <0. 05);外周血IL-6及IL-21细胞因子较治疗前表达水平降低(P <0. 05);外周血IFN-γ及CXCL13较治疗前表达未见明显统计学差异(P> 0. 05)。结论补肾益髓胶囊可以明显地降低NMOSD患者的EDSS评分及中医症状评分,降低外周血促炎因子IL-6及IL-21细胞因子的表达水平,减少Tfh淋巴细胞亚群分布,改善NMOSD患者的炎性环境。

Objective To study the effects and mechanisms of Bushen Yisui capsule on T follicular helper cells(Tfh),interleukin(IL)6,interferon(IFN)γ,C-X-C motif ligand(CXCL)13and IL-21levels in peripheral blood with neuromyelitis optica spectrum disorders(NMOSD)during remission.Methods A total of twenty-five NMOSD patients during remission were enrolled in the study and patients were intervened by Bushen Yisui capsule for3months.CD4+PD1+CXCR5+Tfh subsets in peripheral blood of NMOSD patients were detected by flow cytometry.Plasma levels of IL-6,IFN-γ,CXCL13and IL-21were detected using protein microarray.Results After3months of treatment with Bushen Yisui capsule in patients with NMOSD remission,the expanded disability status scale(EDSS)scores and traditional Chinese medicine(TCM)clinical scores decreased significantly(P<0.05or P<0.01).The distribution of Tfh subsets in peripheral blood of NMOSD patients were down regulated by3months treatment with Bushen Yisui capsule(P<0.05).The IL-6and IL-21levels in plasma of NMOSD patients were down regulated by Bushen Yisui capsule treatment(P<0.05).There was no significant difference in expression of IFN-γand CXCL13by Bushen Yisui capsule treatment(P>0.05).Conclusions Bushen Yisui capsule could down regulate the EDSS scores,TCM clinical scores,IL-6,IL-21and Tfh lymphocyte subsets to improve the inflammatory environment in NMOSD patients during remission.