CD28/CTLA-4在类风湿关节炎患者外周血和关节积液中的表达及意义

Expressions of CD28 and CTLA-4 in peripheral blood and synovial fluid lymphocytes in patients with rheumatoid arthritis and the significance

目的 探讨T细胞辅助刺激分子CD2 8和CTLA 4在类风湿关节炎 (rheumatoidarthritis ,RA)中的表达及其与疾病活动的相关性。方法 采集患者外周抗凝血和关节积液 ,通过淋巴细胞分离液密度梯度离心法分离其中的淋巴细胞 ,采用流式细胞术双标染色技术 ,检测CD3 + CD2 8+ 和CD3 + CTLA 4+ 在淋巴细胞上的表达 ,通过Spearman相关进行统计分析 ,评价其与疾病活动的相关性。结果 ①RA患者外周血单个核细胞 (PBMC)CD3 + CD2 8+ 的表达显著低于正常对照组和RA患者关节积液 (SFMC)组 (P <0 0 1) ;②RA患者PBMC上CD3 + CTLA 4+ 的表达与正常组无差异 ,但显著低于SFMC组(P <0 0 5 )。③SFMC组CD3 + CD2 8+ 的表达与正常组无显著性差异 ,但CD3 + CTLA 4+ 的表达显著高于正常组 (P <0 0 1)④PBMC组、SFMC组CD3 + CD2 8+ 和CD3 + CTLA 4+ 的表达与反映疾病活动性的指标RF、抗CCP抗体存在相关关系。结论 RA患者外周血和关节积液中CD2 8+ 和CTLA4的表达异常是参与RA发病和病情进展的重要机制之一。

Objective To study the expressions of co stimulatory factors CD28 and CTLA 4 on CD3 + T cells in peripheral blood lymphocytes (PBMC) and synovial fluid lymphocytes (SFMC) in patients with rheumatoid arthritis (RA) and the relationship of these molecules with the activity of RA. Methods The lymphocytes were collected from the peripheral blood and synovial fluid in RA patients. The CD3 +CD28 + and CD3 +CTLA 4 + molecules on these cells were measured by dual color fluorescence cytometry. The correlation of the expressions of CD3+CD28+ and CD3 +CTLA 4 + molecules with the activity of RA was statistically analyzed by Spearman. Results ① The level of CD3 +CD28 + in PBMC of RA patients was significantly lower than that of the control group and SFMC ( P <0 01). ② The expression of CD3 +CTLA 4 + in PBMC was not significantly different from that of the control group, but lower than that of SFMC ( P <0.05). ③ The expression of CD3 +CD28 + in SFMC of RA patients was not significantly different from that of control group, but the expression of CD3 +CTLA 4 + was significantly higher than that of the control group ( P <0 01). ④ The expressions of CD28 and CTLA 4 were partly associated with the activity of RA. Conclusion The abnormal expression of CD28 and CTLA 4 molecules in peripheral blood lymphocytes and synovial fluid lymphocytes is one of the important mechanisms involved in the genesis and progression of RA, but the definite roles in the process of the disease are not clear.