摘要
目的检测多发性硬化(MS)患者外周血中CD4+CD28-和CD8+CD28-T细胞亚群的变化并揭示其临床意义。方法收集37例MS患者(MS组,复发期23例、缓解期14例)和33例健康对照(对照组)外周血标本(复发期患者进行甲泼尼龙治疗),采用流式细胞仪检测患者CD28-T细胞数量及其表面CD25、CD45RA和CD45RO的表达,以扩展残疾状况评分量表(Expanded Disability Status Scale,EDSS)评分评价神经功能缺损情况。比较分析MS患者外周血CD28-T细胞亚群,CD28-T细胞亚群表面CD25、CD45RA和CD45RO的表达情况,以及MS患者不同疾病分期及糖皮质激素治疗前后CD28-T细胞亚群变化情况,并分析CD28-T细胞亚群变化与MS患者神经功能缺损及年龄的相关性。结果与对照组比较,MS组CD4+CD28-T细胞数量升高(P=0.000)而CD8+CD28-T细胞数量降低(P=0.001)。MS组中,与CD4+CD28-T细胞比较,CD4+CD28-T细胞CD45RO表达升高,CD25和CD45RA表达下降(均P=0.000);与CD8+CD28+T细胞比较,CD4+CD28-T细胞CD45RO表达降低(P=0.000)。与MS缓解期患者及对照组比较,MS复发期患者CD4+CD28-T细胞数量均明显升高、CD8+CD28-T细胞数量均明显降低(均P<0.05)。糖皮质激素治疗升高CD8+CD28-T细胞数量(P=0.028),而对CD4+CD28-T细胞无影响(P=0.128)。患者EDSS评分与CD4+CD28-T细胞数量呈正相关(r=0.621,P=0.000),与CD8+CD28-T细胞数量呈负相关(r=-0.364,P=0.027)。患者年龄与CD4+CD28-T细胞数量呈正相关(r=0.386,P=0.018),与CD8+CD28-T细胞数量不相关(r=0.120,P=0.479)。结论MS患者外周血中异常变化的CD28-T细胞亚群具有不同的免疫表型,与疾病的复发、治疗和神经功能缺损有关,提示该T细胞亚群失衡可能在MS的免疫病理进程中有一定的作用。
Objective To reveal the changes and clinical significance of CD4+CD28-and CD8+CD28-T-cell subsets in multiple sclerosis(MS)patients.Methods 37 MS patients and 33 health controls(HC)were recruited in this study.CD4+CD28-and CD8+CD28-T cells were detected by flow cytometer.Expressions of CD25,CD45RA and CD45RO on CD28-T-cell subsets were analyzed simultaneously.Results Elevated percentages of CD4+CD28-T cells but reduced percentages of CD8+CD28-T cells were observed in MS patients as compared with those in HC(P=0.000,P=0.001).In MS patients,higher CD45RO but lower CD45RA and CD25 expressions were found on CD4+CD28-T cells than CD4+CD28+T cells(all P=0.000).As compared with CD8+CD28+T cells,CD45RO expressions were reduced on CD8+CD28-T cells(P=0.000).In relapsing patients,increased CD4+CD28-but decreased CD8+CD28-T-cell percentages were observed compared to remitting patients and HC(all P<0.05).Moreover,methylprednisolone therapy evidently increased CD8+CD28-T-cell percentages but had no significant effects on CD4+CD28-T cells in relapsing MS patients(P=0.028,P=0.128).EDSS of MS patients were positively correlated with percentages of CD4+CD28-T cells(r=0.621,P=0.000)but negatively correlated with percentages of CD8+CD28-T cells(r=-0.364,P=0.027).Meanwhile,the ages of MS patients were finely correlated with the percentages of CD4+CD28-T cells(r=0.386,P=0.018).Conclusions In MS patients,abnormally changed CD28-T-cell subsets demonstrated distinct immunophenotypes and were associated with disease relapse,therapy and severity.These observations indicate that imbalance of CD28-T-cell subsets may be involved in the immune process of MS.
作者
蒋觉安
刘翠平
薛群
方琪
俞立强
张陆陆
蒋建华
JIANG Juean;LIU Cuiping;XUE Qun;FANG Qi;YU Liqiang;ZHANG Lulu;JIANG Jianhua(Department of Neurology,The First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215031,China)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2019年第6期391-396,共6页
Chinese Journal of Neuroimmunology and Neurology
基金
国家自然科学基金项目(81873876)
苏州大学自然科学基金预研项目(SDY2012B25)
苏州市“步长杯”神经病学科研重点项目
江苏省社会发展重点病种规范化诊疗项目(BE2016670)。
