强直性脊柱炎患者CD16^(+)单核细胞及表面分子变化特征研究

Changes of CD16^(+)Monocytes and Surface Molecules in Patients with Ankylosing Spondylitis

目的探讨强直性脊柱炎(AS)患者应用英夫利昔单抗治疗过程中CD16^(+)单核细胞亚型及其表面分子的变化特征,为AS临床诊治提供新的实验诊断学指标.方法选择AS患者40例,健康对照组40名.AS患者应用英夫利昔单抗治疗,在0、4和12周3个时间节点采集标本,健康对照组只采集1次标本.应用多参数流式细胞技术检测外周血经典、中间和非经典单核细胞亚型及各亚型细胞表面HLA-DR和CD11b表达量,动态分析各时间节点所检测指标的变化特征.结果AS组用药治疗前(0周)CD16^(+)单核细胞(中间型和非经典型单核细胞)百分率高于健康对照组(P<0.05),经典型单核细胞百分率低于健康对照组(P<0.05);AS组各亚型单核细胞表面HLA-DR和CD11b表达量高于健康对照组(P<0.05).AS组在应用英夫利昔单抗治疗过程中,CD16^(+)单核细胞百分率及表面HLA-DR和CD11b的表达量均呈现下降趋势,12周与0周比较差异具有统计学意义(P<0.05).结论检测CD16^(+)单核细胞亚群,特别是CD14^(hi)CD16^(+)的中间型单核细胞亚群及表面活化相关标志、黏附相关标志在AS的诊断和治疗过程中具有重要临床意义.

Objective To investigate the changes of monocyte subtypes and surface molecules in ankylosing spondylitis(AS)patients treated with infliximab,and to provide new experimental diagnostic indicators for the clinical diagnosis and treatment of AS.Method Forty patients with AS and 40 healthy controls were selected.The AS patients were treated with Infliximab,and the samples were collected at the time nodes of week 0,4 and 12,while the healthy control group only collected samples once.The expression of HLA-DR and CD11b on classical,intermediate and non classical monocyte subtypes and cell surface of each subtype in peripheral blood was detected by multi parameter flow cytometry,and the change characteristics of detected indicators at each time node were dynamically analyzed.Results Before treatment(0 week),the percentage of CD16^(+)monocytes(intermediate and non classical monocytes)in AS group was higher than that in healthy control group(P<0.05),while the percentage of classical monocytes was lower than that in healthy control group(P<0.05);The expression of HLA-DR and CD11b on the surface of monocytes of each subtype in AS group was higher than that in healthy control group(P<0.05).In AS group,during the treatment with Infliximab,the percentage of CD16^(+)monocytes and the expression of HLA-DR and CD11b on the surface of CD16^(+)monocytes showed a downward trend.There was a statistically significant difference between 12 weeks and 0 weeks(P<0.05).Conclusion The CD16^(+)monocyte subsets,especially the intermediate monocyte subsets of CD14^(hi)CD16^(+)and surface activation related markers and adhesion related markers,have certain changes in the diagnosis and treatment of AS,and detection of these indicators will have important clinical significance.