黏膜相关恒定T细胞在强直性脊柱炎患者中的表达及临床意义

Mucosal-associated invariant T cells expression and its clinical significance in ankylosing spondylitis

目的探讨黏膜相关恒定T细胞(MAIT细胞)在AS患者外周中的表达,并分析其临床意义。方法选择2020年9月至2022年9月于福建省立医院就诊64例AS患者,60名健康对照,流式细胞仪检测外周血中MAIT细胞和CD69+MAIT细胞的水平,对骶髂关节MRI进行加拿大脊柱骨关节研究协会评分系统(SPARCC)评分,并结合临床资料进行分析。随访7例治疗后的AS患者,观察病情改善后MAIT细胞的变化。采用t检验、方差分析和Pearson相关分析进行统计处理。结果AS患者外周MAIT细胞水平为[(2.81±0.27)%],低于健康对照组[(4.46±0.86)%](t=2.33,P=0.022);CD69+MAIT细胞在AS中的水平为[(12.0±1.0)%],高于健康对照组[(7.8±1.2)%](t=2.31,P=0.024)。CD69+MAIT细胞与AS患者ESR(r=0.39,P=0.010)、CRP(r=0.36,P=0.012)、ASDAS评分(r=0.35,P=0.013)和SPARCC评分(r=0.38,P=0.006)均呈正相关。7例经过治疗的AS患者,ASDAS评分明显下降(F=7.62,P=0.007),CD69+MAIT细胞水平也降低(F=4.97,P=0.027)。结论AS患者外周的MAIT细胞水平低于健康对照,但活化的MAIT细胞水平升高;活化的MAIT细胞有可能在一定程度上反映AS疾病的炎症状态和病情活动情况,以及骶髂关节的炎性破坏,并可能提示治疗效果;MAIT细胞有可能部分参与了AS的炎症反应。

Objective To investigate the expression of Mucosal-associated invariant T(MAIT)cells in the peripheral blood of ankylosing spondylitis(AS)patients,and to analyze its clinical significance.Methods Sixty-four AS patients from September 2020 to September 2022 in Fujian Provincial Hospital and 60 healthy controls were enrolled.The expression of MAIT cells and CD69+MAIT cells were detected by immunofluorescence.Spondylarthritis research consortium of Canada(SPARCC)scores of sacroiliac joint magnetic resonance imaging(MRI)were calculated and were analyzed based on clinical data.The changes of MAIT cells were observed in 7 patients with AS after treatment.t test,variance analysis and Pearson correlation analysis were used for statistical analysis.Results The expression of MAIT cells in the peripheral of AS patients was significantly lower than that in the controls[(2.81±0.27)%and(4.46±0.86)%respectively,t=2.33,P=0.022],while CD69+MAIT cells were significantly higher[(12.0±1.0)%and(7.8±1.2)%respectively,t=2.31,P=0.024].The level of CD69+MAIT cells were significantly positively correlated with erythrocyte sedimentation rate(ESR)(r=0.39,P=0.010),C-reactive protein(CRP)(r=0.36,P=0.012),ASDAS(r=0.35,P=0.013)and SPARCC scores(r=0.38,P=0.006)of AS patients.ASDAS scores and CD69+MAIT cells obviously decreased in 7 treated AS patients(F=7.62,P=0.007 and F=4.97,P=0.027 respectively).Conclusion The expression of peripheral MAIT cells in AS patients is lower than that in healthy controls,but the number of the activated MAIT cells is increased.Levels of activated MAIT cells may in some extent reflect the inflammatory state and disease activity of AS,as well as inflammatory destruction of sacroiliac joint,and therapeutic effect.MAIT cells may partially participate in the inflammatory response and play a role in the pathogenesis of AS.