CAJ | 학술논문

目的探讨类风湿关节炎(RA)患者外周血调节性T细胞(Tregs)比例的变化情况,了解Tregs变化在RA发病及炎症活动中的意义.方法采用流式细胞仪三色荧光抗体标记法分别对25例RA患者和31名健康志愿者(HV)的外周血淋巴细胞进行CD4、CD25及CD127标记,分析比较RA患者组与HV组间淋巴细胞中CD4+CD25+、CD4+CD25high、CD4+CD25+CD127-及CD4+CD25highCD127-细胞比例的差异情况,并将RA组相应细胞比例与RA疾病活动性评分(DAS28-4)、压痛关节数、肿胀关节数、晨僵时间、医生和患者对疾病活动性的整体评价(VAS)、血红细胞沉降率、C-反应蛋白行相关分析.结果 RA组外周血淋巴细胞中,CD4+CD25+CD127-和CD4+CD25highCD127-细胞占CD4+T淋巴细胞的百分率分别为(2.53±0.85)%和(0.91±0.32)%,而HV组则分别为(3.22±0.97)%和(1.25±0.41)%.CD4+CD25+CD127+和CD4+CD25highCD127-细胞比例在RA组均明显低于HV组,其组间差异均有统计学意义(均P<0.05);另外,RA患者CD4+CD25+CD127-和CD4+CD25highCD127-T细胞比例均与DAS28-4及压痛关节数存在负相关(P<0.05),CD4+CD25highCD127-T细胞还与肿胀关节数及患者VAS存在负相关(P<0.05).结论 RA患者外周血淋巴细胞存在Tregs比例的降低,Tregs数量的异常可能是RA发病及炎症活动的重要影响因素.
목적 탐토류풍습관절염(RA)환자외주혈조절성T세포(Tregs)비례적변화정황,료해Tregs변화재RA발병급염증활동중적의의.방법 채용류식세포의삼색형광항체표기법분별대25례RA환자화31명건강지원자(HV)적외주혈림파세포진행CD4、CD25급CD127표기,분석비교RA환자조여HV조간림파세포중CD4+CD25+、CD4+CD25high、CD4+CD25+CD127-급CD4+CD25highCD127-세포비례적차이정황,병장RA조상응세포비례여RA질병활동성평분(DAS28-4)、압통관절수、종창관절수、신강시간、의생화환자대질병활동성적정체평개(VAS)、혈홍세포침강솔、C-반응단백행상관분석.결과 RA조외주혈림파세포중,CD4+CD25+CD127-화CD4+CD25highCD127-세포점CD4+T림파세포적백분솔분별위(2.53±0.85)%화(0.91±0.32)%,이HV조칙분별위(3.22±0.97)%화(1.25±0.41)%.CD4+CD25+CD127+화CD4+CD25highCD127-세포비례재RA조균명현저우HV조,기조간차이균유통계학의의(균P<0.05);령외,RA환자CD4+CD25+CD127-화CD4+CD25highCD127-T세포비례균여DAS28-4급압통관절수존재부상관(P<0.05),CD4+CD25highCD127-T세포환여종창관절수급환자VAS존재부상관(P<0.05).결론 RA환자외주혈림파세포존재Tregs비례적강저,Tregs수량적이상가능시RA발병급염증활동적중요영향인소.
Objective To study the proportion of regulatory T cells (Tregs) in peripheral blood of patients with rheumatoid arthritis (RA) and investigate the significance of Tregs change in the incidence and inflammatory activity of RA. Methods Three-color fluorescence flow cytometry was used to detect the CD4, CD25 and CD127 markers in the peripheral blood lymphocytes of 25 RA patients and 31 healthy volunteers (HVs). The proportions of CD4+CD25+, CD4+CD25high, CD4+ CD25+ CD127- and CD4+ CD25high CD127- cells were compared between the two groups and correlation analysis was conducted between Tregs and disease activity indices which including disease activity score (DAS28-4), tender joint count (TIC), swollen joint count (SJC), time of morning stiffness, patient's global assessment of disease activity on a 100 mm VAS by doctor and patients, erythrocyte sedimentation rate and C-reactive protein. Results The proportions of CD4+ CD25+ CD127- and CD4+ CD25highCD127- cells in CD4+ peripheral T lymphocytes were (2.53±0.85)% and (0.91±0.32)% respectively in RA group,while they were (3.22±0.97)% and (1.25±0.41)% in HV group. Both of the proportions of CD4+ CD25+ CD127- and CD4+ CD25high CD127- cells were lower in RA group comparing with HV group, and both were significantly different between the two groups (P < 0.05). Correlation analysis indicated signifieant negative correlations of the proportions of CD4+ CD25+ CD127- and CD4+ CD25high CD127- cells with DAS28-4 and TJC (P <0.05), furthermore, CD4+ CD25highCD127- T cells still showed siguifieant negative correlation with the SJC and patient's global assessment of disease activity on a 100 nun VAS by patients (P < 0.05). Conclusion The proportion of Tregs decreased in peripheral blood lymphocytes of patients with RA and the abnormality of Tregs may play an important role in the incidence and inflammatory activity of RA.