滤泡辅助性T细胞在重症肌无力伴胸腺瘤患者胸腺中的表达

Expression of T follicular helper cells in myasthenia gravis patients with thymoma

目的探讨滤泡辅助性T细胞(Tfh)在重症肌无力(MG)伴胸腺瘤患者胸腺组织中的表达变化。方法采用免疫荧光染色技术、免疫组织化学法和蛋白质印迹法,检测30例MG伴胸腺瘤患者(MG组)、20例无MG的胸腺瘤患者(NMG组)的瘤旁组织及10例心脏手术患者(对照组)萎缩胸腺组织中的Tfh细胞比例及其蛋白分子CXCR-5、ICOS、PD-1和Bcl-6的表达水平。结果与NMG组和对照组相比,MG组胸腺组织中Tfh细胞比例及其CXCR-5、ICOS、PD-1和Bcl-6的表达水平显著增高,差异有统计学意义(P<0.05);NMG组胸腺组织中Tfh细胞比例及其CXCR-5、ICOS表达水平显著高于对照组,差异有统计学意义(P<0.05);NMG组与对照组胸腺组织中Tfh细胞PD-1和Bcl-6的表达水平差异无统计学意义(P>0.05)。结论 MG伴胸腺瘤患者瘤旁胸腺组织中的Tfh可能通过提高自身免疫活性参与MG的发生和进展,抑制Tfh信号通路可能为MG的治疗提供新途径。

Objective To investigate role of thymic T follicular helper(Tfh)cells in the immunopathogenesis of myasthenia gravis(MG)patients with thymoma.Methods The percentage of Tfh cells were detected in 30 MG patients with thymoma(MG group),20 non-MG patients with thymoma(NMG group)and 10 individuals with atrophic thymus(control group).The marker protein CXCR-5,ICOS,PD-1 and Bcl-6 were analyzed by immunofluorescence,immunohistochemical staining,and Western blotting.Results Compared with the NMG group and the control group,the Tfh cells and the expression of CXCR-5,ICOS,PD-1 and Bcl-6 protein were increased,the differences were statistically significant(P<0.05).The percentage of Tfh cells and the expression of CXCR-5,ICOS in the NMG group were significantly higher than those in the control group(P<0.05);there was no significant difference in the expression of PD-1 and Bcl-6 between the NMG group and the control group(P>0.05).Conclusion Tfh cells in the peritumoral thymus of the MG patients with thymoma may involve in the generation and development of MG via enhancing immune activity.Inhibiting the immune function of Tfh cells may provide a new strategy approaching for the treatment of MG.