系统性红斑狼疮治疗前后外周血共刺激分子表达的变化和意义

Costimulators in patients with systemic lupus erythematosus before and after treatment

目的探讨共刺激分子表达水平在系统性红斑狼疮(SLE)患者治疗前后的变化及其意义。方法采用免疫荧光标记流式细胞仪检测技术,对SLE患者和正常人外周血单个核细胞膜表面的共刺激分子表达水平进行测定分析。结果①与正常人相比,SLE患者CD28分子表达显著降低(P<0.01),其中双标记CD4+CD28+、CD8+CD28+T细胞均显著减少(P<0.01),4-1BB分子表达显著增高(P<0.01);②患者CD28分子、CD4+CD28+及CD8+CD28+T细胞与SLE病情活动指数(SLEDAI)呈负相关(分别为P<0.01、P<0.01、P<0.05),4-1BB分子与SLEDAI呈正相关(P<0.01);③患者治疗后CD28分子、CD4+CD28+及CD8+CD28+T细胞随病情缓解而上升(P<0.01),4-1BB分子随病情缓解而下降(P<0.01)。结论共刺激分子表达异常在SLE发病机制中可能具有重要作用,其中CD28分子、4-1BB分子、CD4+CD28+及CD8+CD28+T细胞对监测病情活动和判断疗效可能具有重要意义。

Objective: To investigate the level of costimulators in patients with systemic lupus erythematosus (SLE) before and after treatment. Methods: The level of costimulators in peripheral blood of SLE patients before and after treatment and normal persons were detected by immunofluorescence lebelled technology and flow cytometry analysis. Results: ①Compared with normal subjects, the level of CD28 including CD4+CD28+,CD8+CD28+ T cells in peripheral blood of SLE patients was significantly decreased (P < 0.01), while the level of 4-1BB was increased (P < 0.01). ②The change in CD28 including CD4+CD28+,CD8+CD28+ T cells correlated with SLE disease activity index (SLEDAI) negatively (P < 0.01) and the change in 4-1BB correlated with SLEDAI positively. ③The level of CD28 was increased (P < 0.01), while the level of 4-1BB was decreased (P < 0.01)when the disease was controlled. Conclusions: Abnormal expression of costimulators may play some roles in pathogenesis of SLE. CD28, 4-1BB, CD4+CD28+ and CD8+CD28+ T cells may be useful indicators in the observation of disease activity and efficacy assessment of treatment.