CAJ | 학술논문

目的观察COPD稳定期患者体内是否存在CD_8~+CD_(25)~+Foxp_3~+调节性T细胞(Treg细胞),以及M受体拈抗剂噻托溴铵对其表达的影响.方法 2007年10月至2008年3月,选择23例COPD稳定期患者,每日1次吸入噻托溴铵18 μg,连续治疗3个月.分别在治疗前后榆查患者的肺功能和检测外周血中T细胞亚群的数量.两组间均数比较采用配对t检验,相关分析采用直线相关分析.结果 COPD稳定期患者在吸入噻托溴铵治疗后,外周血巾CD_4~+为(36±46)%,CD_8~+CD_(25)~+Treg 细胞为(21±21)%,明显高于治疗前的(28±10)%和(8±8)%;CD_4~+CD_(25)~+为(4±3)%,明显低于治疗前的(10±7)%,差异均有统计学意义(t值为2.72～3.78,P<0.01和P<0.05).CD_8~+、CD_8~+CD_(25)~+和CD_4~+CD_(25)~+Treg细胞均有表达,但治疗前后无明显变化.治疗后肺通气功能得到明显改善,FEV_1、FEV_1占预计值%和FEV_1/FVC分别由(1.0±0.3)L、(35±10)%和(41±8)%提高到(1.1±0.3)L、(40±11)%和(45±11)%,差异均有统计学意义(t值为2.37～2.65,均P<O.05).相关分析结果表明,治疗前后CD_4~+和CD_4~+CD_(25)~+的变化差值与CD_8~+CD_(25)~+Treg细胞的变化率显呈著负相关(r值分别为-0.61和-0.72,P<0.05和P<O.01).结论 M受体拈抗剂噻托溴铵可能具有增强细胞免疫和免疫抑制的功能.CD_8~+CD_(25)~+Treg和CD_4~+CD_(25)~+Treg可能成为了解患者免疫状况,判断疗效和疾病免疫分型的一组新指标.
목적 관찰COPD은정기환자체내시부존재CD_8~+CD_(25)~+Foxp_3~+조절성T세포(Treg세포),이급M수체념항제새탁추안대기표체적영향.방법 2007년10월지2008년3월,선택23례COPD은정기환자,매일1차흡입새탁추안18 μg,련속치료3개월.분별재치료전후유사환자적폐공능화검측외주혈중T세포아군적수량.량조간균수비교채용배대t검험,상관분석채용직선상관분석.결과 COPD은정기환자재흡입새탁추안치료후,외주혈건CD_4~+위(36±46)%,CD_8~+CD_(25)~+Treg 세포위(21±21)%,명현고우치료전적(28±10)%화(8±8)%;CD_4~+CD_(25)~+위(4±3)%,명현저우치료전적(10±7)%,차이균유통계학의의(t치위2.72～3.78,P<0.01화P<0.05).CD_8~+、CD_8~+CD_(25)~+화CD_4~+CD_(25)~+Treg세포균유표체,단치료전후무명현변화.치료후폐통기공능득도명현개선,FEV_1、FEV_1점예계치%화FEV_1/FVC분별유(1.0±0.3)L、(35±10)%화(41±8)%제고도(1.1±0.3)L、(40±11)%화(45±11)%,차이균유통계학의의(t치위2.37～2.65,균P<O.05).상관분석결과표명,치료전후CD_4~+화CD_4~+CD_(25)~+적변화차치여CD_8~+CD_(25)~+Treg세포적변화솔현정저부상관(r치분별위-0.61화-0.72,P<0.05화P<O.01).결론 M수체념항제새탁추안가능구유증강세포면역화면역억제적공능.CD_8~+CD_(25)~+Treg화CD_4~+CD_(25)~+Treg가능성위료해환자면역상황,판단료효화질병면역분형적일조신지표.
Objective To investigate the levels of peripheral CD_8~+CD_(25)~+Foxp_3~+ regnlary T cells (CD_8~+CD_(25)~+ Treg)in stable chronic obstructive pulmonary disease(COPD)patients,and the effect of muscarinic cholinergic receptor antagonist,tiotropium bromide,on the expression of CD_8~+ CD_(25)~+ Treg.Methods From Oct.2007 to Mar.2008,23 patients with stable moderate to severe COPD received tiotropium bromide inhalation(1 8 μg daily)for 3 months.Before and after the use of tiotropium bromide,lung function was performed and peripheral vein blood samples were collected from the patient.Lymphocytes were isolated by three-color labeled monoelonal antibodies flow cytometry to detect the quantity and percentage of CD_8~+ T cell,CD_8~+ CD_(25)~+ T cell,CD_8~+ CD_(25)~+ Treg,CD_4~+ T cell,CD_4~+ CD_(25)~+ T cell and CD_4~+ CD_(25)~+ Treg,respectively.Paired t test was used for comparison between data before and after treatment.Results In patients with stable COPD.after tiotropium bromide treatment,the percentage of CD_4~+ T cells was increased from(28±10)% to (36±6)%,and the difference was significant(t=3.20,P<0.01).CD_4~+CD_(25)~+ was decreased from(10±7)%to(4±3)%(t=3.78,P<0.01),and CD_8~+ CO_(25)~+ Treg was incteased from(8±8)%to(21±21)%(t=2.72,P<0.05).At baseline,CD_8~+ cells,CD_8~+ CD_(25)~+ cells and CD_~+ CD_(25)~+ Treg were detectable in the peripheral blood,but no significant changes were observed after trealmenL After ireatment with tiotropium bromide,the lung function was markedly improved;FEV_1,FEV_1/Pre%.and FEV_1/FVC were increased from(1.0±0.3)L,(35±10)%and (41±8)%to(1.1±0.3)L.(40±11)%and(45±11)%,respectively(t=2.65,2.56 and 2.37,respectively,all P<0.05).By linear correlation analysis,the quantity of changes of CD_4~+ T cels and CD_4~+ cD_(25)~+ T cells were negatively correlated with the rate of change in CD_8~+ CD_(25)~+ Treg(r=-0.61,P<0.05 and r=-0.72,P<0.01,respectively).Conclusions In the peripheral blood of patients with stable COPD.there was expression of CD_8~+ CD_(25)~+ Treg and CD_4~+ CD_(25)~+ Treg The muscarinic receptor antagonist tiotropium bromide,promoted the amplification of CD_4~+,inhibited the expression of CD_(25)~+,and enhanced the expression of CD_8~+ Treg,suggesting that muscarinic receptor antagonist tiotropium bromide may possess immunomodulation function.