强直性脊柱炎患者外周血CD8^+CD28^-和CD8^+CD28^+的表达及意义

THE SIGNIFICANCE OF CD8^+ CD28^- T CELLS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

目的探讨强直性脊柱炎(Ankylosing Spondylitis,AS)患者外周血中CD8^+CD28^-、CD8^+CD28^+、CD8^-CD28^+T细胞亚群在AS细胞免疫中所发挥的作用。方法采用流式细胞技术对30例未经治疗的活动期AS患者及30例健康对照人群外周血中的CD8^+CD28^-、CD8^+CD28^+、CD8^-CD28^+T细胞亚群进行检测,并探讨DNT与Bath AS功能指数(BASFI)、Bath AS测量指数(BASMI)、病程、年龄及实验室炎性指标血沉(ESR)、超敏C反应蛋白(hs-CRP)的相关性。结果 30例AS患者与30例正常对照组外周血测定结果比较发现:AS患者外周血中CD8^+CD28^-明显升高,CD8^+CD28^+则明显降低,与正常对照组比较差异具有统计学意义(P均<0.001)。AS患者外周血CD8^+CD28^-细胞亚群水平与血沉、HsCRP、BASFI指数、BASMI指数呈正相关(P<0.01);CD8^+CD28^+细胞与血沉、BASFI指数呈负相关(P<0.05),与Hs-CRP、BASMI无明确相关性;CD8^+CD28^+、CD8^+CD28^-细胞亚群水平与AS患者的年龄、病程均无明显相关性;CD8^-CD28^+与AS患者病程、年龄、血沉、Hs-CRP、BASFI指数、BASMI指数均无明确相关性(P>0.05)。结论 AS患者外周血存在T淋巴细胞亚群紊乱,检测外周血CD8^+CD28^-水平对AS的诊断和疾病活动性判断有重要价值,有助于早期发现病情活动,为判断病情和制定治疗策略提供更好的依据。

Objective To detect CD8^+CD28^-、CD8^+CD28^+、CD8^-CD28^+T cells in AS patients and to explore its value in the pathogenesis of AS,and analyse the value for the clinical application in the treatment of AS.Methods CD8^+CD28^-,CD8^+CD28^+,CD8^-CD28^+T cells were quantified in the peripheral blood of30 patients in active stage of AS and 30 healthy controls by flow cytometry.The correlations of DNT cells with BASFI,BASMI,the duration of disease,age,ESR,hs-CRP were analyzed.Results Compared with CD8^+CD28^-T cells in peripheral bloods of the control group(19.23±7.21)%,CD8^+CD28^-T cells of AS patients(26.53±5.37)% were increased significantly(P<0.001);CD8^+CD28^+T cells and CD8^-CD28^-T cells in the peripheral blood of AS patients was lower than healthy controls(P<0.001);CD8^+CD28^+T cells was negatively correlated with ESR(r=^-0.431,P<0.05)and BASFI(r=^-0.442,P<0.05);while CD8^+CD28^-T cells was positively correlated with ESR(r=0.652,P<0.01),hs-CRP(r=0.599,P<0.01),BASMI(r=0.726,P<0.01)and BASFI(r=0.895,P<0.01).However,there was no significant difference between CD8^+CD28^-T cells,CD8^+CD28^+T cells and the duration of disease,age.There was no significant difference between CD8^-CD28^-T cells and the duration of disease,age,ESR,hs^-CRP,BASMI and BASFI(P>0.05).Conclusions Our data suggest that the abnomal expression of CD8^+CD28^-T cells,CD8^+CD28^+T cells,CD8^-CD28^-T cells are correlate with AS patients significantly;the expression of CD8^+CD28^-T cells is found to be correlated with disease activity.CD8^+CD28^-T cells may play a important role in the pathogenesis of AS and it can be hopefully used in the treatment of AS patients.