类风湿关节炎患者CD14^(+)HLA-DR-MDSC细胞的变化及临床意义

Changes and clinical significance of CD14^(+)HLA-DR-MDSC cells in patients with rheumatoid arthritis

目的骨髓来源的抑制性细胞(MDSC)在肿瘤患者体内大量增殖并抑制机体免疫,但在自身免疫性疾病中研究较少,本次研究其在类风湿关节炎(RA)中的临床意义。方法选取82例RA患者、82例关节痛患者以及48例健康者作为研究对象。分别抽取3 ml外周血,并用EDTA抗凝管保存。用流式细胞仪检测RA、关节痛患者以及健康者外周血里的单核细胞、CD14^(+)HLA-DR-MDSC细胞的分布频率,并探讨其异常分布与RA患者临床参数的相关性,从而研究其临床意义。结果相比于健康者和关节痛患者,RA患者外周血中MDSC细胞发现明显扩增(P<0.05),其中MDSC细胞数值与RA患者血沉,CCP以及DAS28评分成正相关(r=0.28,r=0.33,r=0.31;P<0.05)。进一步临床分析显示相比未患有间质性病变和心包炎RA患者,间质性病变和心包炎RA患者外周血中MDSC细胞显著增多,差异有统计学意义(P<0.05)。结论CD14^(+)HLA-DR-MDSC细胞与RA疾病进展显著相关,且在RA患者关节外器官病变中可能扮演重要功能。

Objective Bone marrow derived suppressor cells(MDSC)proliferate and inhibit immunity in tumor patients,but the studies of them in autoimmune diseases are inadequate.Thus,this paper aims to study the clinical significance of MDSC in patients with rheumatoid arthritis(RA).Methods Totally,82 rheumatoid arthritis patients,82 arthralgia patients and 48 healthy people were enrolled in this study.3 ml of peripheral blood was extracted and stored with EDTA anticoagulant tube.Flow cytometry was used to detect the monocytes in peripheral blood of patients with RA,arthralgia and healthy people and the distribution frequency of CD14^(+)HLA-DR^(-)MDSC and explore the correlation between their abnormal distribution and clinical parameters in patients with RA,so as to study their clinical significance.Results Compared with healthy people and arthralgia patients,MDSC cells were significantly expanded in peripheral blood of RA patients(P<0.05).The frequency of MDSC cells was positively correlated with ESR,CCP and DAS28 scores of RA patients(r=0.28,T=0.33,r=0.31;P<0.05).Further clinical analysis showed that compared with the group without interstitial lung and pericarditis,MDSC cells were elevated in the group with interstitial lung and pericarditis RA,with the differences statistically significant(P<0.05).Conclusion CD14*HLA-DR'MDSC cells are significantly correlated with the progression of RA,and may play an important role in the progression of extraarticular organs damage in RA patients.