系统性红斑狼疮患者红细胞I型补体受体与细胞免疫的相关关系

Relationship between erythrocyte CR1 and cellular immunity in patients with systemic lupus erythematosus

目的探讨红细胞I型补体受体(CR1)在系统性红斑狼疮(SLE)免疫发病机制、病情活动与激素治疗前后方面中的作用以及与细胞免疫的相关性。方法选自2002年6月至2003年2月我科住院及门诊初诊初治SLE病人39例,其中活动期病人28例,稳定期病人11例。健康献血员30名为对照组。采用红细胞CR1与红细胞免疫复合物花环试验检测RBC-CR1与红细胞免疫复合物(RBC-IC)花环率。对活动期患者在予糖皮质激素治疗前,治疗后2周、4周各测1次RBC-CR1、RBC-IC花环率。流式细胞仪测定CD4+、CD8+、CD4+/CD8+及CD3+细胞数。结果①活动期SLE组RBC-CR1花环率(4.4±3.6)%明显低于稳定期组(8.9±3.3)%及对照组(9.6±4.3)%,RBC-IC花环率(12.9±9.5)%明显高于稳定期组(6.2±2.6)%及对照组(5.7±2.8)%。稳定期SLE组与对照组比较,RBC-CR1与RBC-IC花环率差异均无显著性(P>0.05)。②治疗后2周、4周与治疗前比较,RBC-CR1花环率显著升高(P<0.01),但仍低于对照组(P<0.05)。RBC-IC花环率显著降低(P<0.01),但仍高于对照组(P<0.05)。③活动期、稳定期SLE组与对照组比较,CD4+、CD3+细胞数差异无显著性;CD8+细胞数明显升高;CD4+/CD8+比值明显下降。④RBC-CR1花环率与CD4+(r=0.40,P<0.05)、CD4+/CD8+(r=0.41,P<0.05)均呈正相关,与CD8+(r=-0.42,P<0.05)。

Objective To investigate the role of erythrocyte CR1 in the pathogenesis,disease activity evaluation and cell immunity of systemic lupus erythematosus (SLE).Methods This study was carried out in 39 cases of SLE patients.Twenty-eight were newly diagnosed active SLE patients,the other 11 cases were stable SLE patients.Thirty cases of healthy donors served as normal controls.The rosette experiments of RBC-CR1 and RBC-IC were used to measure the erythrocyte CR1 immune function.CD4+,CD8+,CD4+/CD8+ and CD3+ were determined by flow cytometry.Results ①The rosette ratio of RBC-CR1 was significantly lower in the active SLE patients (4.4±3.6)% than that in the stable SLE patients (8.9±3.3)% and the normal controls (9.6±4.3)%.The rosette ratio of RBC-IC was significantly higher in the active SLE patients (12.9±9.5)% than that in the stable SLE patients (6.2±2.6)% and the normal controls (5.7±2.8)%; No change was found between the stable SLE patients and the normal controls(P>0.05).②After 2~4 weeks of treatment,the rosette ratio of RBC-CR1 in the active SLE patients became significantly higher than before treatment(P<0.01),but still lower than that of the normal controls(P<0.05).After 2~4 weeks of treatment,the rosette ratio of RBC-IC in the active SLE patients became significantly lower than before treatment(P<0.01),but still higher than that of the normal controls(P<0.05).③ No change was found in both CD4+ and CD3+ expression of peripheral leucocytes(P>0.05),CD8+ celluar computation was significantly higher,CD4+/CD8+ ratio was significantly lower in the active SLE patients than that in the normal controls(P<0.01).④The rosette ratio of RBC-CR1 was positively correlated with CD4+(r=0.40,P<0.05) and CD4+/CD8+(r=0.41,P<0.05),but negatively correlated with CD8+(r=-0.42,P<0.05)and DAI(r=-0.65,P<0.01).It has no correlation with CD3+ in the active SLE patients(P>0.05).Conclusion The ability of erythrocyte CR1 to recognize,adhere and clear CIC is reduced in the active SLE patients.The relationship between CR1 and cellular immunity is found.This conclusion might further the SLE pathogenesis study.