双阴性T细胞对抗中性粒细胞胞质抗体相关性血管炎的影响

Influence of double-negative T cells on ANCA associated vasculitis

目的分析抗中性粒细胞胞质抗体相关性血管炎(AAV)患者外周血中双阴性T细胞(DNT)的表达情况。方法选取50例AAV患者(AAV组),按照疾病活动情况分为活动组36例和缓解组14例;按照有无肾损害分为肾损害组32例和非肾损害组18例。同期招募30例健康志愿者作为对照组。比较AAV组患者与对照组DNT细胞及胞内细胞因子白细胞介素17(IL-17)、白细胞介素4(IL-4)和γ干扰素(IFN-γ)水平的差异及与患者临床指标的相关性。结果AAV组患者DNT、IL-17及IFN-γ水平高于对照组(P<0.05),而IL-4低于对照组(P<0.05)。AAV患者活动组DNT、IL-17水平高于缓解组(P<0.05)。AAV患者肾损害组DNT和IL-17水平高于非肾损害组(P<0.05)。AAV患者DNT与红细胞沉降率(ESR)、血清肌酐(Scr)、24h尿蛋白、伯明翰评分、抗中性粒细胞胞质抗体滴度呈正相关(P<0.05);IL-17与Scr、24h尿蛋白呈正相关(P<0.05),而IL-4、IFN-γ与临床指标无相关性(P>0.05)。结论DNT与AAV的发病有相关性。

Objective To analyze the expression level of double-negative T cells in peripheral blood of patients with ANCA-associated vasculitis (AAV). Methods Fifty patients with ANCA-related vasculitis were selected . They were divided into active group (n = 36), inactive group (n = 14), renal damage group (n = 32) and non-renal damage group (n = 18). At the same time, thirty healthy volunteers were taken as control group. The levels of DNT cells, IL-17, IL-4 and IFN-γ in DNT cells were compared between normal persons and different types of AAV patients. Correlation between the level of DNT cells and the levels of IL-17, IL-4, IFN-γ in patients with AAV and clinical indicators were analyzed. Results The expression levels of DNT cells and IL-17, IFN-γ in AAV patients were higher than those of normal persons, while the level of IL-4 was lower than that of normal persons (P < 0.05). The levels of DNT cells and IL-17 in AAV active group were higher than those in non-active group (P < 0.05). The levels of DNT cells and IL-17 in AAV patients with renal impairment were higher than those in non-renal impairment patients (P < 0.05). In AAV patients, DNT was positively correlated with ESR, creatinine, 24-hour urinary protein and Birmingham score;IL-17 was positively correlated with creatinine and 24-hour urinary protein, while IL-4 and IFN-γwere not correlated with all clinical indicators. Conclusions DNT cells are associated with the incidence of ANCAassociated vasculitis.