玫瑰痤疮患者外周血滤泡辅助性T细胞和滤泡调节性T细胞的测定和意义初探

A preliminary study on the measurement and clinical significance of follicular helper T cell and follicular regulatory cells in peripheral blood of rosacea patients

目的探讨玫瑰痤疮(rosacea)患者外周血中滤泡辅助性T细胞(follicular helper T cell,Tfh)和滤泡调节性T细胞(follicular T regulatory cell,Tfr)频率与疾病的相关性。方法选择我院收治的129例玫瑰痤疮患者,以同期来院体检的38例健康人作为对照组,利用流式细胞术检测血液中Tfh和Tfr细胞的频率,并分析性别、年龄、不同亚型及其治疗前后的变化,同时采用受试者工作特征(ROC)曲线评价该类细胞与疾病的关联性。结果患者外周血CD4^(+)T细胞中Tfh和Tfr细胞频率均高于对照组;男性和女性患者之间没有差异,而30岁以上的患者Tfh和Tfr细胞频率显著升高;红斑毛细血管扩张型(ETR)、丘疹脓疱型(PPR)以及二者表型兼具患者中Tfh和Tfr细胞频率显著高于对照组和鼻赘型(PhR)患者;治疗后Tfh和Tfr细胞频率较治疗前显著降低;ROC曲线分析发现Tfh和Tfr细胞的曲线下面积(AUC)分别为0.68和0.629,且有统计学差异。结论玫瑰痤疮患者外周血CD4^(+)T细胞中Tfh和Tfr细胞频率升高,提示Tfh和Tfr细胞可能通过调控B细胞的类别转换参与玫瑰痤疮疾病相关免疫应答。

The current study was designed to assess the correlation between the frequency of follicular helper T(Tfh)and follicular regulatory T(Tfr)cells in peripheral and the disease of rosacea.Peripheral blood samples were collected from 129 patients with rosacea and 38 healthy controls in our hospital.Frequencies of Tfh and Tfr in peripheral blood were detected by flow cytometry,and compared between rosacea patients and healthy controls in considering of gender,age,different subtypes and their changes before and after treatment.Receiver operating characteristic(ROC)curves were calculated to evaluate the association of Tfh and Tfr with disease.Data showed that frequencies of Tfh and Tfr cells in patients were elevated,as compared with healthy control;there was no difference in frequencies of Tfh and Tfr cells between male and female patients.The frequency of Tfh and Tfr cells in patients over 30 years increased significantly.Tfh and Tfr cell frequencies in patients with erythematotelangiectatic rosacea(ETR),papulopustular rosacea(PPR)or both phenotypes were significantly higher than those of healthy control and phytomatous rosacea(PhR)patients.There was a significant decrease in the frequency of Tfh and Tfr cells after treatment.The area under the curve(AUC)of Tfh and Tfr cells using ROC were 0.68 and 0.629,respectively,and there were statistical differences.In conclusion,the frequencies of Tfh and Tfr in peripheral blood CD4^(+)T cells of patients with rosacea are increased before treatment,suggesting Tfh and Tfr cells might involve in the immune response ofrosacea by regulating the class switch of B cells.