摘要
目的探索不同疾病状态SLE患者外周调节T细胞（CD4^＋CD25^＋Foxp3^＋ T细胞）的分布特征、功能及其与SLE器官损害的关系。方法用流式细胞术检测206例SLE患者和38名健康对照组外周CD4^＋CD25^＋Foxp3^＋ T细胞数量、功能性分子（CTLA-4、GITR及ICOS）及细胞因子（IFN-γ、IL-17和IL-10）的表达，分析其与疾病活动及器官损害的关系，比较其在不同治疗方案下的变化。运用SPSS 21.0软件，采用成组t检验、单因素方差分析、Mann-Whitney U检验、Kruskal-Wallis检验、χ^2检验、相关分析等统计方法进行数据分析。结果活动期SLE患者[11.9%（9.3%，16.0%）]及非活动期SLE患者CD4^＋CD25^＋Foxp3^＋ T细胞[11.0%（7.7%，14.7%）]均高于健康对照组[6.1%（5.3%，7.4%）]（均值差分别为104.71及86.10，P均〈0.01）。SLE患者CD4^＋CD25^＋Foxp3^＋ T细胞与SLEDAI-2K（r=0.191，P〈0.05）、抗dsDNA抗体（r=0.262，P〈0.05）、ESR（r=0.208，P〈0.05）及IgG（r=0.163，P〈0.05）呈正相关，与C3（r=-0.201，P〈0.05）和C4（r=-0.227，P〈0.05）呈负相关。合并器官损害的SLE患者的CD4^＋CD25^＋Foxp3^＋ T细胞高于无明显器官受累的隐匿型狼疮患者，尤其是合并皮肤损害[10.9%（7.8%，13.1%），均值差为56.93，P〈0.05]及肾脏损害[12.1%（9.1%，16.0%），均值差为77.26，P〈0.05]的SLE患者。治疗后SLE患者的CD4^＋CD25^＋Foxp3^＋T细胞比例与初发未治疗的患者相比差异无统计学意义。SLE患者CD4^＋CD25^＋Foxp3^＋ T细胞CTLA-4[（53±15）%]、GITR[（42±19）%]及ICOS[（28±9）%]的表达均低于健康对照组[CTLA-4（71±4）%、GITR（53±10）%及ICOS（41±6）%，t值分别为7.04、2.64、4.27，P均〈0.01]。SLE患者CD4^＋CD25^＋Foxp3^＋ T细胞合成的IL-17[3.0%（1.8%，3.9%）]高于健康对照组[1.0%（0.7%，1.2%），Z=-4.40，P〈0.01]。结论SLE患者调节性T细胞数量较健康对照显著升高，并与SLE疾病活动及器官损害有�
ObjectiveTo explore the distribution characteristics and function of peripheral regulatory T cells （CD4^＋CD25^＋Foxp3^＋ T cells） in patients with systemic lupus erythematosus （SLE）. In addition, we analyzed the relationship between peripheral regulatory T cells and organ damage and the influence of different treatment regimens on them.MethodsTwo hundred and six SLE patients and 38 healthy volunteers were enrolled, which included 12 patients with untreated new-onset lupus, 11 patients with drug withdrawal more than six months and 183 patients with treatments. Phenotypic and functional analysis of peripheral blood CD4^＋ CD25^＋Foxp3^＋ T cells were performed by flow cytometry. The correlations of CD4^＋CD25^＋Foxp3^＋ T cells with disease activity, organ involvement were analyzed. Thealtered frequency of CD4^＋CD25^＋Foxp3^＋ T cells under different treatment regimens was compared. Statistical Package form Soci-science （SPSS） 21.0 software was used for data analysis, Student＇s t test, one-way ANOVA, Mann-Whitney T test, Kruskal-Wallis test, Chi-square test, Simple linear correlation analysis was used.ResultsCD4＋CD25＋Foxp3＋ T cells were significantly increased inactive SLE patients [11.9% （9.3%,16.0%）,mean difference=104.71, P〈0.01] and inactive SLE patients [11.0%（7.7%, 14.7%）, mean difference=86.10, P〈0.01] compared with healthy controls [6.1%（5.3%, 7.4%）]. CD4^＋CD25^＋Foxp3^＋ T cellsshowed sign-ificantly positive correlations with SLEDAI-2K （r=0.191, P〈0.05）, dsDNA （r=0.262, P〈0.05）, ESR （r=0.208, P〈0.05） and lgG （r=0.163, P〈0.05）, and significantly negatively correlated with complement C3 （r=-0.201, P〈0.05） and C4 （r=-0.227, P〈0.05）. Compared with patients without organ damage （Occult lupus）, the CD4^＋CD25^＋Foxp3^＋ T cells were increased in SLE patients with organ damage, especially those with skin involvement [10.9% （7.8%, 13.1%）, mean difference=56.93, P〈0.05] and renal involvement [12.1%（9.1%, 16.0%�
作者
殷子婧
朱丽
胡楠
冯秀媛
罗静
王静
俱博苗
蒲丹
吕晓虹
何岚
Yin Zijing;Zhu Li;Hu Nan;Feng Xiuyuan;Luo Jing;Wang ring;Ju Bomiao;Pu Dan;Lv Xiaohong;He Lan(Department of Rheurnatologyand Immunology,the First Affiliated Hospital of X i＇an Jiaotang University,Shaanxi 710061,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2018年第10期664-671,I0001,共9页
Chinese Journal of Rheumatology
基金
陕西省自然科学基础研究计划项目（2010JM4035）
西安交通大学第一附属医院青年创新基金（YK20151）
关键词
红斑狼疮
系统性
调节性T细胞
器官损害
免疫抑制剂
Lupus erythematosus
systemic
T-lymphocytes
regulatory
Organ damage
Immuno-suppressive agents
