摘要
Objective To investigate the change of circulating follicular helper T cells(cTfh)in patients with anti-neutrophil cytoplasmic myeloperoxidase antibody-associated vasculitis(MPO-AAV),and to analyze the relationship between cTfh and disease activity.Methods Thirty-eight untreated MPO-AAV patients(patient group)and thirty-eight healthy volunteers(control group)were enrolled in this study.cTfh and membrane expression of inducible co-stimulator(ICOS)and programmed cell death protein 1(PD-1)were detected by flow cytometry(FCM).Serum anti-neutrophil cytoplasmic myeloperoxidase antibody(MPO-ANCA)was measured by ELISA.Disease activity was evaluated by Birmingham vasculitis activity score(BVAS).Results Compared with those in the control group,the proportions of cTfh,ICOS^+Tfh and PD-1^+ Tfh cells in patient group were significantly higher [(25.9±3.8)% vs.(21.0±5.3)%,P<0.001;(1.8±0.8)% vs.(0.8±0.5)%,P<0.001 and(10.2±2.8)% vs.(8.2±2.2)%,P=0.001,respectively].Meanwhile,the expression of ICOS and PD-1 on cTfh in the patient group was markedly more intensive(59.6±10.0 vs.49.2±6.9,P<0.001 and 532.6±104.2 vs.485.1±73.4,P=0.025,respectively).In the patient group,the proportion of cTfh was positively correlated with the ratio of ICOS+Tfh,the expression of ICOS,the level of MPO-ANCA and BVAS(r=0.407,P=0.011;r=0.705,P<0.001;r=0.737,P<0.001 and r=0.663,P<0.001,respectively).The expression intensity of ICOS on cTfh was positively associated with ICOS^+Tfh ratio,serum MPO-ANCA and BVAS(r=0.388,P=0.016;r=0.645,P<0.001 and r=0.653,P<0.001,respectively).Nevertheless,the expression of PD-1 on cTfh was only positively correlated with the ratio of PD-1^+Tfh(r=0.473,P=0.003).Conclusion Enhanced cTfh in patients with MPO-AAV might produce MPO-ANCA,which is related to the aggravation of MPO-AAV.Thus,cTfh and its ICOS could be potentially targeted for the treatment of MPO-AAV.
作者
WANG Sen
王森(Dept Rheumatol & Immunol,1st Affil Hosp,Anhui Med Univ)
