Vogt-小柳原田综合征患者外周血和脑脊液淋巴细胞共刺激分子的表达

Expression of lymphocyte costimulatory molecules in peripheral blood and cerebral spinal fluid on patients with Vogt-Koyanagi-Harada syndrome

目的 探讨Vogt-小柳原田综合征 (VKH)患者外周血及脑脊液淋巴细胞上B7、CD2 8和CTLA -4分子的表达及意义。方法 采用流式细胞三色直接免疫荧光标记法 ,检测了 3 9例VKH综合征患者外周血T、B淋巴细胞亚群上共刺激分子CD80 (B7-1)、CD86(B7-2 )、CD2 8和CTLA -4的表达。VKH综合征患者分为葡萄膜炎活动期 (18例 )和静止期 (2 1例 )两组。对于 3例初发的VKH综合征患者 ,我们还检查了脑脊液中T淋巴细胞上共刺激分子的表达。结果 VKH综合征活动期患者外周血CD4+ T细胞表面CD2 8分子的表达有所增高 (97 0 %± 3 71% ,正常人为 95 3 %±3 19% ) ,而静止期患者有所下降 (93 7%± 7 5 6% ) ,但三组比较无显著差异。静止期患者CD4+ T细胞表面CTLA -4分子的表达 (2 72 %± 1 42 % )显著高于正常人 (1 73 %± 0 66% ) (P <0 0 5 )。另外 ,VKH综合征活动期患者外周血CD4+ 和CD8+ T细胞表面CD86分子的表达显著低于静止期患者和正常人 (P <0 0 5 )。与自身外周血淋巴细胞比较 ,3例初发VKH综合征患者脑脊液CD4+ T细胞显著增多 (t=3 3 2 5 ,P <0 0 5 ) ,CD4/CD8比值显著升高 (t =3 2 76,P <0 0 5 ) ,CD2 8分子的表达也显著增高 (t =4 2 42 ,P <0 0 5 )。结论 VKH病患者外周血及脑脊液淋巴细胞上B7、CD2

Objective To investigate the expression of lymphocyte costimulatory molecules(B7,CD28 and CTLA-4)on patients with Vogt-Koyanagi-Harada(VKH)syndrome,and determine the role of costimulatory molecules in VKH syndrome.Methods Thirty-nine patients with VKH syndrome were analyzed by direct three-color immunofluorescence flow cytometry for expression of CD80(B7-1),CD86(B7-2),CD28 and CTLA-4 on T and B cells of peripherial blood.Patients were divided into active(18 cases)and stable groups(21 cases).Expression of lymphocyte costimulatory signals in cerebral spinal fluid were also examined on 3 incipient patients.Results Expression of CD28 on CD4+ T cells was upregulated in active patients with VKH disease(97.0%±3.71%)compared to controls(95.3%±3.19%),decreased in stable patients(93.7%±7.56%),but there were no significant differences among these groups.Significant increased expression of CTLA-4 on CD4+ subsets was seen in patients with stable disease(2.72%±1.42%)compared to controls(1.73%±0.66%)(P<0.05).The expression of CD86 on CD4+ and CD8+ subsets in active patients were significantly decreased compared to controls and patients with stable disease(P<0.05).Compared to peripheral blood lymphocytes,CD4+T cells (t=3.325,P<0.05)and CD4+/CD8+ ratio(t=3.276,P<0.05) in cerebral spinal fluid were significantly upregulated in 3 incipient patients with VKH disease,and expression of CD28 on lymphocytes in cerebral spinal fluid was also upregulated.(t=4.242,P<0.05).Conclusions These data indicates costimulatory signals contribute to the onset,persistence and convalescence of uveitis and other pathologic changes in patients with VKH syndrome.