滤泡辅助性T细胞(Tfh)和激活B细胞在帕金森病患者外周血中的水平及意义

Level and significance of follicular helper T cells(Tfh)and activated B cells in peripheral blood of patients with Parkinson′s disease

目的:探讨帕金森病(PD)患者外周血中滤泡辅助性T细胞(Tfh)和激活B细胞的水平变化及临床意义。方法:选择PD患者73人,健康对照25人。PD患者按照Hoehn-Yahr分期法(H-Y)分为Ⅰ~Ⅳ期。检测外周血单个核细胞(PBMC)中CD4+CXCR5+ICOS+Tfh细胞比例和CD83+CD19+B细胞的比例及Bcl-6、IL-21、IL-4的mRNA水平和外周血中IL-21表达水平。结果:PD患者外周血中Tfh细胞比例和B细胞比例显著高于健康人外周血,且Tfh和B细胞比例具有相关性。PD患者Ⅰ~Ⅳ期外周血中Tfh的比例分别为(1.35±0.52)%、(2.65±0.33)%、(4.52±0.62)%、(5.95±0.68)%,低于健康人水平,差异有统计学意义;B细胞比例相比健康人低,差异有统计学意义;PD患者外周血中IL-21水平高于健康人,差异有统计学意义。PD患者外周血PBMC中Bcl-6、IL-21和IL-4的mRNA水平高于正常人,差异有统计学意义,且与H-Y分期有关。结论:PD患者外周血PBMC中Tfh和B细胞比例上调,其关键细胞因子IL-21、Bcl-6和IL-4的水平也上调,提示免疫系统参与PD的进展。

Objective:To investigate the changes and clinical significance of follicular helper T cells(Tfh)and activated B cells in peripheral blood of patients with Parkinson′s disease(PD).Methods:73 patients diagnosed with PD and 25 healthy subjects were selected.According to the Hoehn-Yahr staging method,patients with PD were divided into I~IV.Proportion of CD4+CX⁃CR5+ICOS+Tfh cells and CD83+CD19+B cells and mRNA levels of Bcl-6,IL-21,IL-4 in peripheral blood mononuclear cells(PBMC)and expression level of IL-21 were detected.Results:Proportion of Tfh cells and B cells in peripheral blood of patients with PD were significantly higher than that of healthy subjects,and proportion of Tfh cells and B cells was correlated.Proportion of Tfh in peripheral blood of PD patients in stageⅠ~Ⅳwas(1.35+0.52)%,(2.65+0.33)%,(4.52+0.62)%,(5.95+0.68)%,respectively,which were lower than that in healthy subjects,and the difference was significant.Level of IL-21 in peripheral blood of PD patients was higher than that of healthy people,and the difference was statistically significant.Levels of Bcl-6,IL-21 and IL-4 in peripheral blood PBMC of PD patients were higher than those of normal controls,the difference was statistically significant,and were correlated with H-Y staging.Conclusion:Proportion of Tfh and B cells in peripheral blood PBMC of patients with PD and levels of key cytokines IL-21,Bcl-6 and IL-4 are up-regulated,suggesting that the immune system is involved in the development and progress of PD.