淋巴细胞亚群及炎症因子与自身免疫性脑炎的相关性

Correlation between lymphocyte subsets,inflammatory factors and autoimmune encephalitis

目的探讨外周血淋巴细胞亚群及炎症因子与自身免疫性脑炎的相关性。方法收集自身免疫性脑炎患者静脉血,流式细胞技术检测自身免疫性脑炎患者治疗前后各淋巴细胞亚群百分比,流式免疫荧光发光法检测相关细胞因子,改良Rankin量表(mRS)评估一线免疫治疗前后的评分。结果自身免疫性脑炎患者免疫治疗前CD8^(+)T细胞(r=0.779,P<0.001)和IL-10(r=0.480,P=0.044)与mRS评分呈正相关,CD4^(+)/CD8^(+)T细胞比值与mRS评分呈负相关(r=—0.632,P<0.001),差异均有统计学意义(P<0.05)。一线免疫治疗后CD8^(+)T细胞(P=0.001)、IL-6(P=0.015)和IL-8(P=0.018)水平较治疗前下降,而CD4^(+)/CD8^(+)T细胞比值较治疗前升高(P=0.02),差异有统计学意义(P<0.05)。结论外周血CD4^(+)T、CD8^(+)T细胞比例与疾病活动之间存在相关性,通过观察外周血淋巴细胞亚群比例变化,可用来评估自身免疫脑炎的疗效,有助于进一步判断治疗的给药剂量和给药周期。另外,未发现炎症因子与自身免疫性脑炎之间存在相关性。

Objective To determine the correlation between blood lymphocyte subsets,inflammatory fac⁃tors and autoimmune encephalitis.Methods We collected the venous blood of patients with autoimmune encephalitis(AE),the percentage of lymphocyte subsets before and after treatment in patients with autoimmune encephali⁃tis was measured using flow cytometry,and the relevant cytokines were detected using flow immunocytofluorome⁃try,and the scores before and after first-line immunotherapy were assessed by the modified Rankin scale(mRS).Results Before immunotherapy,CD8^(+)T cells(r=0.779,P<0.001)and IL-10(r=0.480,P=0.044)were positively correlated with mRS score,and CD4^(+)/CD8^(+)T cell ratio(r=—0.632,P<0.001)was negatively correlated with mRS score,the correlation is statistically significant(P<0.05).After first-line immunotherapy CD8^(+)T cells(P=0.001),IL-6(P=0.015)and IL-8(P=0.018),the levels decreased compared to pre-treatment,while the CD4^(+)/CD8^(+)T cell ratio(P=0.02)increased compared to pre-treatment,with statistically significant differences(P<0.05).Conclu⁃sion A correlation was observed between the peripheral blood CD4^(+)T and CD8^(+)T cell ratio and disease activity and relapse.This relationship should be further explored to guide the dose and period of drug administration for disease treatment.Additionally,the relationship suggests the possibility of using changes in peripheral blood lym⁃phocyte subtype ratios to monitor the efficacy of treatment regimens.No correlation between inflammatory factors and autoimmune encephalitis disease activity was found in this study.