CAJ | 학술논문

目的探讨CD28-T细胞亚群在类风湿关节炎(RA)患者外周血和关节液中的变化和意义。方法随机选择RA患者45例，取新鲜抗凝外周血单个核细胞(PBMC)，其中15例同时提取关节液单个核细胞( SFMC),以流式细胞技术检测CD28-T细胞数量及其表面可诱导共刺激分子(ICOS)的表达。2 组间比较用独立样本t检验。结果 ①与PBMC相比，RA患者SFMC中CD4+CD28+ ICOS+、CD4+CD28-ICOS+、CD8+ CD28+、CD8+ CD28+ ICOS+T细胞明显升高[(36±19)％与(15±8)％,t=-4.234,P＜0.01；(2.1±2.2)％与(0.6±1.4)％,t=-3.143,P＜0.01;(62±15)％与(47±18)％,t=-2.885,P＜0.01;(9±9)％与(3±3)％，t=-2.131，P＜0.05]；CD8+CD28-T细胞明显降低[(38±15)％与(54±18)％，t=2.975，P＜0.01]；CD8+ CD28- ICOS+、C1D4+CD28+和CD4+CD28-T细胞无明显变化（P＞0.05）。②同一RA患者SFMC与PBMC相比，CD4+CD28+ICOS+、CD8+ CD28+T细胞明显升高[(38±18)％与(16±10)％，t=-4.065，P＜0.01；(61±16)％与(41±21)％，t=-2.883，P＜0.01]；CD8+ CD28-T细胞明显降低[(39±16)％与(59±21)％，t=2.949,P＜0.01]。③缓解期与活动期RA患者相比，PBMC中CD4+CD28-、CD8+ CD28-、CD28-ICOS+T细胞无明显变化（P＞0.05）。结论 RA患者关节液中CD28-T细胞亚群失衡和ICOS分子表达异常，可能是导致RA关节损伤的重要机制。
목적 탐토CD28-T세포아군재류풍습관절염(RA)환자외주혈화관절액중적변화화의의。방법 수궤선택RA환자45례，취신선항응외주혈단개핵세포(PBMC)，기중15례동시제취관절액단개핵세포( SFMC),이류식세포기술검측CD28-T세포수량급기표면가유도공자격분자(ICOS)적표체。2 조간비교용독립양본t검험。결과 ①여PBMC상비，RA환자SFMC중CD4+CD28+ ICOS+、CD4+CD28-ICOS+、CD8+ CD28+、CD8+ CD28+ ICOS+T세포명현승고[(36±19)％여(15±8)％,t=-4.234,P＜0.01；(2.1±2.2)％여(0.6±1.4)％,t=-3.143,P＜0.01;(62±15)％여(47±18)％,t=-2.885,P＜0.01;(9±9)％여(3±3)％，t=-2.131，P＜0.05]；CD8+CD28-T세포명현강저[(38±15)％여(54±18)％，t=2.975，P＜0.01]；CD8+ CD28- ICOS+、C1D4+CD28+화CD4+CD28-T세포무명현변화（P＞0.05）。②동일RA환자SFMC여PBMC상비，CD4+CD28+ICOS+、CD8+ CD28+T세포명현승고[(38±18)％여(16±10)％，t=-4.065，P＜0.01；(61±16)％여(41±21)％，t=-2.883，P＜0.01]；CD8+ CD28-T세포명현강저[(39±16)％여(59±21)％，t=2.949,P＜0.01]。③완해기여활동기RA환자상비，PBMC중CD4+CD28-、CD8+ CD28-、CD28-ICOS+T세포무명현변화（P＞0.05）。결론 RA환자관절액중CD28-T세포아군실형화ICOS분자표체이상，가능시도치RA관절손상적중요궤제。
Objective To investigate the expression and significance of CD28- cells, CD4+ and CD8+T lymphocytes in the peripheral blood and synovial fluid in patients with rheumatoid arthritis ( RA ). Methods The expression of CD28, CD4+, CD8+ T lymphocytes and inducible co-stimulator (ICOS) in the peripheral blood and synovial fluid in 45 patients with RA were detected by three-color flow cytometry. Independent sample's t test was used for statistical analysis between the two groups. Results Synovial fluid CD4+CD28+ICOS+, CD4+CD28- ICOS+ , CD8 + CD28 + , CD8 + CD28 + 1COS+ T lymphocytes were significantly increased than the peripheral blood in RA patients[(36±19)％ vs (15±8)％, t=-4.234, P＜0.01; (2.1±2.2)％ vs (0.6±1.4)％, t=-3.143, P＜0.01; (62±15)％ vs (47±18)％, t=-2.885, P＜0.01; (9±9)％ vs (3±3)％,t=-2.131, P＜0.05], Synovial fluid CD8+CD28-T lymphoc-ytes were significantly reduced than the peripheral blood[(38±15)％ vs (54±18)％, t=2.975, P＜0.01], Synovial fluid CD8+ CD28-ICOS+, CD4+CD28+and CD4+ CD28- T lymphocytes had no significant difference than the peripheral blood (P＞0.05). Compared with peripheral blood in the same patients with RA, CD4+CD28+ ICOS+, CD8+ CD28+ T lymphocyteswere significantly increased[(38±18)％ vs (16±10)％, t=-4.065, P＜0.01 ; (61±16)％ vs (41±21)％, t=-4.065,P＜0.01], CD8+CD28-T was significantly reduced[(39±16)％ vs (59±21)％, t=2.949, P＜0.01]. The level of CD4+ CD28-, CD8+ CD28-, CD28-ICOS+ T lymphocytes in the active and remission patients with RA was not significantly different (P＞0.05). Conclusion Synovial fluid CD28T lymphocyte subsets disturbance and the abnormal expression of ICOS in patients with RA may play important roles in the mechanism of joint damage.