CAJ | 학술논문

目的观察调节性T(Treg)细胞在急性肝衰竭(ALF)患者外周血中的比率、活性变化及其临床意义.方法选取20名ALF患者及10名健康对照者,分离外周血单个核细胞(PBMCs).应用流式细胞术检测各组患者PBMCs中CD4+ CD25+ CD127low Treg细胞占CD4+细胞的比率.通过单向混合淋巴细胞反应(MLR),观察从各组患者PBMCs中分离的CD4+CD25+CD127lowTreg细胞抑制淋巴细胞增殖的能力变化.同时检测外周血中超敏C反应蛋白(hsCRP)、血沉(ESR)、免疫球蛋白(Ig)等水平.结果 ALF患者PBMCs中Treg细胞占CD4+细胞的比率明显低于健康对照者[(4.20±1.34)％比(8.34±0.89)％,t=8.81,P＜0.01].加入ALF患者分离得到的Treg细胞的MLR,Treg细胞抑制同源性PBMCs细胞增殖的能力被明显削弱,cpm=(21.48±4.14)×103；与健康对照者cpm=(6.32±1.18) x103]比较差异有统计学意义(t=11.26,P＜0.01).而ALF患者外周血hsCRP、ESR、Ig水平明显高于健康对照者(P＜0.05).ALF患者外周血Treg细胞下降与hsCRP和1gG升高呈负相关(r=-0.634,P＜0.01；r=-0.596,P＜0.01).结论 ALF患者存在Treg细胞数量及活性的下降,Treg细胞等免疫调节因素可能在ALF的发病机制中发挥作用.
목적 관찰조절성T(Treg)세포재급성간쇠갈(ALF)환자외주혈중적비솔、활성변화급기림상의의.방법 선취20명ALF환자급10명건강대조자,분리외주혈단개핵세포(PBMCs).응용류식세포술검측각조환자PBMCs중CD4+ CD25+ CD127low Treg세포점CD4+세포적비솔.통과단향혼합림파세포반응(MLR),관찰종각조환자PBMCs중분리적CD4+CD25+CD127lowTreg세포억제림파세포증식적능력변화.동시검측외주혈중초민C반응단백(hsCRP)、혈침(ESR)、면역구단백(Ig)등수평.결과 ALF환자PBMCs중Treg세포점CD4+세포적비솔명현저우건강대조자[(4.20±1.34)％비(8.34±0.89)％,t=8.81,P＜0.01].가입ALF환자분리득도적Treg세포적MLR,Treg세포억제동원성PBMCs세포증식적능력피명현삭약,cpm=(21.48±4.14)×103；여건강대조자cpm=(6.32±1.18) x103]비교차이유통계학의의(t=11.26,P＜0.01).이ALF환자외주혈hsCRP、ESR、Ig수평명현고우건강대조자(P＜0.05).ALF환자외주혈Treg세포하강여hsCRP화1gG승고정부상관(r=-0.634,P＜0.01；r=-0.596,P＜0.01).결론 ALF환자존재Treg세포수량급활성적하강,Treg세포등면역조절인소가능재ALF적발병궤제중발휘작용.
Objective To explore the changes of regulatory T (Treg) cell proportion and activity in peripheral blood of patients with acute liver failure (ALF).Methods Twenty patients with ALF and 10 healthy controls were selected in this study.Peripheral blood mononuclear cells (PBMCs) were obtained by using density gradient centrifugation.The proportion of CD4 + CD25 + CD127low Treg cells in the CD4 + cells was detected by using flow cytometry in PBMCs of enrolled cases.The immune activity of Treg cells isolated from PBMCs was observed by using a suppression assay of allogeneic mixed lymphocyte response (MLR).In addition,the levels of high sensitivity C reactive protein (hsCRP),erythrocyte sedimentation rate (ESR) and immunoglobulin in peripheral blood were also detected.Results The patients with ALF had a significantly lower percentage of Treg cells in CD4 + T ceils in PBMCs than healthy controls [(4.20 ±1.34) ％ vs.(8.34 ± 0.89) ％,t =8.81,P ＜ 0.01].The suppressing homologous PBMCs proliferation ability of Treg cells isolated from the patients with ALF was significantly weakened in MLR [cpm =(21.48::4.14) x 103],which had a statistically significant difference compared with healthy controls [cpm =(6.32±1.18) ×103,t=11.26,P＜0.01].The levels of hsCRP,ESR and immunoglobulin in peripheral blood in the patients with ALF were significantly higher than in healthy controls (P ＜ 0.05).The percentage of Treg cells were negatively correlated with hsCRP and IgG (r =-0.634,P ＜ 0.01 ; r =-0.596,P ＜ 0.01).Conclusion There is a decrease in both quantity and activity of Treg cells in the patients with ALF.Treg cells and other immuno-rcgulation factors may play an important role in the pathogenesis of ALF.