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目的探讨系统性红斑狼疮(SLE)患者CD4+CD25+调节性T细胞(Tr)及其细胞因子的改变。方法用流式细胞仪直接免疫荧光法检测SLE患者外周血CD4+CD25+T细胞的百分率,FoxP3+分子表达,细胞因子IL-10,TGF-β1的表达。结果 SLE患者活动期组、稳定期组、健康对照组CD4+CD25+T细胞占CD4+T细胞的百分率分别是(3.57±1.45)%,(5.14±1.63)%,(6.03±1.96)%。活动期患者明显低于稳定期患者和健康对照组,差异均有统计学意义(P均<0.05)。CD4+CD25+FoxP3+T细胞、CD4+CD25-FoxP3+T细胞占CD4+T细胞的百分率,活动期患者明显高于稳定期患者和健康对照组,差异均有统计学意义(P<0.05)。CD4+CD25+FoxP3+T细胞与疾病的活动指数(DAI)正相关(r=0.659,P<0.05);而CD4+CD25-FoxP3+T细胞与DAI无统计学相关性(r=0.184,P>0.05)。活动期患者CD4+CD25+IL-10+细胞明显高于稳定期患者和健康对照组,差异均有统计学意义(P均<0.05)。然而CD4+CD25-TGF-β+细胞在活动期患者、稳定期患者和健康对照组之间比较差异无统计学意义(P均>0.05)。结论 SLE患者外周血中Tr细胞数量减少,分泌的IL-10增加,TGF-β减少,可能导致细胞免疫抑制功能减弱,自身免疫耐受平衡被打破,出现激活的自身反应性T细胞增多;此外,T淋巴细胞激活增多,还可辅助B细胞产生更多相关抗体,表现出多种临床症状。
Objective To investigate the changes of CD4 + CD25 + regulatory T cells (Tr) and its cytokines in patients with systemic lupus erythematosus (SLE). Methods The percentage of CD4 + CD25 + T cells, expression of FoxP3 +, expression of cytokines IL-10 and TGF-β1 in peripheral blood of SLE patients were detected by flow cytometry direct immunofluorescence. Results The percentages of CD4 + CD25 + T cells in CD4 + T cells in active phase group, stable phase group and healthy control group were (3.57 ± 1.45)%, (5.14 ± 1.63)% and (6.03 ± 1.96)%, respectively. Active patients were significantly lower than stable patients and healthy controls, the differences were statistically significant (P all <0.05). CD4 + CD25 + FoxP3 + T cells and CD4 + CD25-FoxP3 + T cells in CD4 + T cells in active stage were significantly higher than those in stable stage and healthy control group (all P <0.05) . CD4 + CD25 + FoxP3 + T cells were positively correlated with DAI (r = 0.659, P <0.05). There was no significant correlation between CD4 + CD25 + FoxP3 + T cells and DAI > 0.05). The active CD4 + CD25 + IL-10 + cells were significantly higher than those in stable patients and healthy controls (all P <0.05). However, there was no significant difference in CD4 + CD25-TGF-β + cells between active patients, stable patients and healthy controls (all P> 0.05). Conclusions The number of Tr cells, the secretion of IL-10 and the decrease of TGF-β in peripheral blood of patients with SLE may result in weakened cellular immunosuppression and an imbalance of autoimmune tolerance, resulting in an increase of activated autoreactive T cells. In addition , T lymphocyte activation increased, but also help B cells produce more relevant antibodies, showing a variety of clinical symptoms.