CD39^+CD73^+B细胞亚群在原发性胆汁性胆管炎患者中的变化及其临床价值分析

Changes of CD39^+CD73^+ B cell subsets in patients with primary biliary cholangitis and their clinical value

目的:分析原发性胆汁性胆管炎(PBC)患者外周血CD39^+CD73^+B细胞亚群在B细胞中所占比例的变化,及其与PBC的临床指标间的关系。方法:收集江苏苏州吴江区和常熟地区PBC患者60例,健康人对照者40例,以流式细胞术分析所有研究对象外周血CD39^+CD73^+B细胞在B细胞中的比例,多重微珠流式荧光法定量分析PBC患者抗线粒体抗体M2(AMA-M2)水平,全自动生化分析仪检测肝功能各项指标。统计分析CD39^+CD73^+B细胞比例的组间差异及其与自身抗体和肝脏酶指标之间的关系。结果:PBC患者CD39^+CD73^+B细胞的比例较对照组显著降低[55.6%(44.9%,60.5%)vs 73.0%(69.8%,74.9%),P<0.001]。PBC组CD39^+CD73^+B细胞比例与AMA-M2呈明显的负相关关系(r=-0.349,P=0.027)。抗糖蛋白210抗体(anti-GP210)阳性患者CD39^+CD73^+B细胞比例较anti-GP210阴性患者明显降低[44.6%(38.2%,49.9%)vs 58.7%(49.8%,63.8%),P<0.001],抗核蛋体100抗体(anti-SP100)阳性和阴性患者间CD39^+CD73^+B细胞比例差异无统计学意义[58.6%(47.9%,62.7%)vs 51.6%(44.7%,60.4%),P=0.292]。结论:PBC患者外周血CD39^+CD73^+B细胞比例显著降低,且与特异性自身抗体存在显著相关性,提示该群B细胞在PBC发病过程中可能发挥重要作用。

Objective:To investigate the change of the proportion of CD39^+CD73^+B cell subsets in B cells in peripheral blood of patients with primary biliary cholangitis(PBC)and its correlation with clinical indexes of PBC.Methods:Sixty PBC patients and 40 healthy controls from Wujiang and Changshu Districts of Suzhou were collected.The proportion of CD39^+CD73^+B cell subsets in B cells in peripheral blood of all subjects was analyzed by flow cytometry.The levels of serum anti-mitochondrial antibody M2(AMA-M2)in PBC patients were quantitatively analyzed by the automated multiplexed bead-based assay.The liver function indexes were detected by an automatic biochemical analyzer.The differences of CD39^+CD73^+B cell subsets between groups and their correlations with autoantibodies and liver enzymes were analyzed.Results:The proportion[median(P25,P75)]of CD39^+CD73^+B cell subsets in PBC patients was significantly lower than that in healthy controls[55.6%(44.9%,60.5%)vs 73.0%(69.8%,74.9%),P<0.001].The proportions of CD39^+CD73^+B cell subsets in PBC patients were significantly and negatively correlated with serum AMA-M2 levels(r=-0.349,P=0.027).The proportions of CD39^+CD73^+B cell subsets in PBC patients with positive anti-glycoprotein 210 antibody(anti-GP210)were significantly lower than those with negative anti-GP210[44.6%(38.2%,49.9%)vs 58.7%(49.8%,63.8%),P<0.001].There was no significant difference in the proportion of CD39^+CD73^+B cell subsets between the PBC patients with positive anti-nuclear body protein SP100 antibody(anti-SP100)and negative anti-SP100[58.6%(47.9%,62.7%)vs 51.6%(44.7%,60.4%),P=0.292].Conclusion:The proportion of CD39^+CD73^+B cell subsets in peripheral blood of PBC patients is significantly reduced and correlated with specific autoantibodies,suggesting that these B cell subsets may play an important role in the pathogenesis of PBC.