共刺激分子OX40在急性脑梗死患者外周血调节性T细胞上的表达及其临床意义

Expression of costimulatory molecule OX40 in peripheral regulatory T cells and its clinical significance in patients with acute cerebral infarction

目的探讨急性脑梗死患者外周血调节性T细胞(Treg)上共刺激分子OX40的表达情况及其临床意义。方法选择苏州大学附属第一医院神经内科自2019年4月至l2月收治的75例首次发病的急性脑梗死患者纳入病例组,选择同期招募的年龄、性别与病例组相匹配的36例健康志愿者纳入对照组。采用免疫荧光标记和流式细胞技术检测2组受试者肘静脉血中CD4+CD25+CD127^low Treg细胞上OX40的表达,并分析病例组的OX40^+Treg细胞比例与其美国国立卫生研究院卒中量表(NIHSS)评分、缺血半暗带体积、核心梗死灶体积、梗死灶体积的相关性,同时比较病例组的OX40^+Treg细胞比例在血管内治疗或静脉溶栓前后的变化。结果与对照组比较,病例组的外周血Treg细胞比例明显降低,OX40^+Treg细胞比例明显升高,差异均有统计学意义(P<0.05)。病例组的外周血OX40^+Treg细胞比例与其NIHSS评分呈正相关关系(rs=0.271,P=0.018),与其缺血半暗带体积、核心梗死灶体积、梗死灶体积亦均呈正相关关系(rs=0.435,P=0.000;rs=0.343,P=0.003;rs=0.245,P=0.034)。病例组中血管内治疗患者的术后第7天外周血OX40^+Treg细胞比例较术前明显降低,静脉溶栓患者的术后第3、7天外周血OX40^+Treg细胞比例较术前明显降低,差异均有统计学意义(P<0.05)。结论OX40在急性脑梗死患者外周血Treg细胞上异常表达,并与神经功能缺损、影像学表现及再灌注治疗密切相关。

Objective To investigate the expression of costimulatory molecule OX40 in peripheral CD4^+CD25^+CD127low regulatory T(Treg)cells and its clinical significance in patients with acute cerebral infarction(ACI).Methods Seventy-five patients with first-onset ACI,admitted to our hospital from April 2019 to December 2019,and 36 age-and gender-matched volunteers(control group)were selected in this study.OX40 expression on CD4^+CD25^+CD127low Treg cells in peripheral blood samples in the two groups were analyzed by immunofluorescent labeling and flow cytometry.Correlations of OX40^+Treg cell percentage with National Institute of Health stroke scale(NIHSS)scores,ischemic penumbra volume,core infarct volume,and infarct volume in the patient group were analyzed.The changes of OX40^+Treg cell percentage in the patient group before and after endovascular treatment or intravenous thrombolysis were compared.Results As compared with that in the control group,the Treg cell percentage in peripheral blood samples of the patient group was significantly decreased,while OX40^+Treg cell percentage was significantly increased(P<0.05).OX40^+Treg cell percentage was positively correlated with NIHSS scores in ACI patients(rs=0.271,P=0.018).Meanwhile,OX40^+Treg percentage was significantly correlated with ischemic penumbra volume,core infarct volume,and infarct volume in the patient group(rs=0.435,P=0.000;rs=0.343,P=0.003;rs=0.245,P=0.034).OX40^+Treg cell percentage in ACI patients 7 d after endovascular treatment was significantly decreased as compared with that before treatment(P<0.05);OX40^+Treg percentage in ACI patients 3 and 7 d after intravenous thrombolysis was significantly decreased as compared with that before treatment(P<0.05).Conclusion OX40 is abnormally expressed on peripheral Treg cells in ACI patients,and is closely correlated with neurological deficits,imaging features and reperfusion therapy.