2型糖尿病患者外周血CD8^+CD25^+Foxp3^+Treg细胞检测及意义

Change and significance of CD8^+CD25^+Foxp3^+Treg cells in peripheral blood of patients with type 2 diabetes

目的探讨外周血CD8^+CD25^+Foxp3^+Treg(CD8^+Treg)细胞比例在2型糖尿病(T2DM)疾病过程中的作用。方法选取T2DM患者90例。根据尿微量白蛋白(MAL),分为45例T2DM伴正常蛋白尿患者(NMAU,MAL<30 mg/24 h),45例T2DM伴微量蛋白尿患者(MAU,MAL 30~300 mg/24 h),同时选择门诊体检健康人员45名作为对照组(HC)。通过特定蛋白仪检测患者mAlb浓度;流式细胞仪检测CD8^+Treg细胞比例;Luminex200检测血浆白细胞介素(IL)-8、1β、6和肿瘤坏死因子(TNF)-α浓度。结果与HC组[4.43(3.26~5.75)%]相比,NMAU组[4.06(3.15~5.43)%]和MAU组[3.52(2.30~4.87)%]患者CD8^+Treg细胞比例降低,且MAU组降低更明显(P<0.05);与HC组相比,MAU组和NMAU组患者血浆细胞因子TNF-α、IL-8、IL-6和IL-1β浓度均升高(P<0.05);MAU组患者CD8^+Treg比例与血清细胞因子TNF-α(r=-0.444 8,P<0.01)、IL-8(r=-0.341 2,P<0.05)、IL-6(r=-0.365 3,P<0.05)和IL-1β(r=-0.319 2,P<0.05)呈负相关;Logistic回归分析显示CD8^+Treg对T2DM患者可能具有保护作用。结论通过调控T2DM患者外周血CD8^+Treg细胞比例,有可能减缓糖尿病的进程。

Objective To investigate the role of CD8^+CD25^+Foxp3^+Treg(CD8^+Treg)cells in the pathogenesis of type 2 diabetes(T2DM).Methods Ninety patients with T2DM were selected and divided into NMAU group containing 45 T2DM patients(MAL<30 mg/24 h)and MAU group containing 45 patients with microalbuminuria(MAL 30-300 mg/24 h),based on urinary microalbumin(MAL).Additionally,45 healthy patients were selected as control group(HC).The concentration of mAlb was measured by specific protein analyzer;the proportion of CD8^+Tregs was measured by flow cytometry;and the concentrations of serum interleukin(IL)-8,1β,6,and tumor necrosis factor(TNF)-αwere measured by Luminex200.Results Compared with the HC group[4.43(3.26-5.75)%],the proportion of CD8^+Tregs in the NMAU group[4.06(3.15-5.43)%]and the MAU group[3.52(2.30-4.87)%]were significantly decreased,and lower in MAU group(P<0.05).The serum levels of TNF-α,IL-8,IL-6 and IL-1βin the MAU group and the NMAU group were higher than that of HC group(P<0.05).The percentage of CD8^+Treg cells showed a negative correlation with TNF-α(r=-0.444 8,P<0.01),IL-8(r=-0.341 2,P<0.05),IL-6(r=-0.365 3,P<0.05)and IL-1β(r=-0.319 2,P<0.05)respectively;Logistic regression analysis showed that CD8^+Tregs may have a protective effect on T2DM.Conclusions By regulating the proportion of peripheral blood CD8^+Tregs in patients with T2DM,it is possible to slow down the progression of diabetes.