CD200与CD4+CD25+CD127lowTreg在强直性脊柱炎中的意义

Significance of CD200 and CD4+CD25+CD127lowTreg in ankylosing spondylitis

目的:研究强直性脊柱炎(AS)患者外周血淋巴细胞中CD200的表达水平,分析CD200及Treg与IL-6、SAA的相关性,探讨CD200与AS免疫功能的关系以及诊断效能,为辅助AS的诊断、免疫评估提供帮助。方法:从74例AS患者和50例健康志愿者中收集外周血。流式细胞术检测淋巴细胞亚群、Treg的百分率及CD200的表达率,并用ELISA法检测血清中CD200的浓度,上转发光法测定IL-6的浓度,胶乳免疫比浊法测定SAA的浓度。结果:与对照组相比,AS活动组CD4^+T细胞、CD19^+B细胞的百分率均增高(P<0.05),CD8^+T细胞、Treg的百分率均减低(P<0.05),CD3^+T细胞的百分率无明显差异;稳定组CD4^+T细胞、CD8^+T细胞、CD19^+B细胞、Treg的百分率与对照组均无显著差异。与对照组比较,活动组(CD3^+、CD4^+、CD8^+)T细胞中CD200的表达率和血清中CD200的浓度以及稳定组(CD3^+、CD4^+)T细胞中CD200的表达率和血清中CD200的浓度均减低(P<0.05);而稳定组CD8^+T细胞、CD19^+B细胞中CD200的表达率及活动组CD19^+B细胞中CD200的表达率无显著差异。与对照组比较,活动组血清中IL-6、SAA的浓度明显升高(P<0.05);而稳定组IL-6的浓度轻度升高(P<0.05),SAA的浓度无差异。活动组CD3^+T淋巴细胞中CD200的表达率与Treg呈正相关,与IL-6呈负相关,但与SAA不相关;Treg的百分率与IL-6负相关,与SAA不相关。CD200对AS的诊断优于Treg、SAA,而与IL-6的诊断效能相当。结论:AS活动期患者存在淋巴细胞亚群紊乱,CD200和Treg的表达率降低,两者可能参与了AS的发病,为辅助AS的诊断和免疫功能的判断提供理论依据。

Objective:To study the expression of CD200 in peripheral blood lymphocyte of patients with ankylosing spondylitis,analyze the correlation between CD200 and Treg,IL-6 and SAA,and explore the relationship between CD200 and AS immune function and diagnostic efficacy,so as to provide assistance for the diagnosis of AS.Methods:Peripheral blood was collected from 74 AS patients and 50 healthy volunteers.The percentage of lymphocyte subsets and Treg and the expression rate of CD200 were detected by flow cytometry.The concentration of CD200 in serum was detected by ELISA,the concentration of IL-6 was determined by up-forwarding light method,and the concentration of SAA was determined by latex immunoturbidimetry.Results:Compared with the control group,the percentage of CD4^+T cells and CD19^+B cells increased(P<0.05),the percentage of CD8^+T cells and Treg decreased in the active group(P<0.05),but there was no significant difference in the percentage of CD3^+T cells.There was no significant difference in the percentage of CD4^+T cells,CD8^+T cells,CD19^+B cells and Treg between the stable group and the control group.Compared with the control group,the expression rate of CD200(CD3^+T, CD4^+T, CD8^+T) cells and serum CD200 in the active group and the expression rate of CD200 in(CD3^+,CD4^+) T cells and serum CD200 in the stable group were decreased(P<0.05),while the expression rate of CD200 in CD8^+T cells and CD19^+B cells in the stable group and the expression rate of CD200 in CD19^+B cells in the active group were no significant difference.Compared with the control group,the concentration of IL-6 and SAA in the active group were significantly higher(P<0.05) lower than that in the control group,while the concentration of IL-6 in the stable group was slightly higher(P<0.05),and the concentration of SAA in the stable group was not different from that in the control group.In the active group,the expression rate of CD200 in CD3^+T cells was positively correlated with Treg,and negatively correlated with IL-6,but not correlated with SAA.The percentage of Treg was negatively correlated with IL-6,but not with SAA.The diagnosis of AS by CD200 was superior to that by Treg and SAA,but the diagnostic efficiency of AS was similar to IL-6.Conclusion:In the active stage of AS,there is a disorder of lymphocyte subsets and the expression rate of CD200 and Treg is decreased.Both of them may be involved in the pathogenesis of AS,which provides a theoretical basis for the diagnosis of AS and the judgment of immune function.