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目的探讨2型糖尿病(T2DM)合并血管病变患者外周单核细胞表面负性协同刺激分子程序性死亡配体-1(PD-L1)的表达变化及其生物学作用。方法应用流式细胞术分析单纯糖尿病组(42例)、糖尿病合并大血管病变组(48例)、糖尿病合并急性冠脉综合症组(35例)和健康对照组(48例)外周血中单核细胞表面PD-L1分子的表达水平,同时检测各T淋巴细胞亚群表面程序性死亡受体1(PD-1)的表达;采用ELISA法检测各组血清中肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)等细胞因子浓度。结果与健康对照组相比,糖尿病三个组患者外周单核细胞表面PD-L1表达均显著增加(P<0.05),并与血管病变的严重程度呈正相关,而CD4+和CD8+T淋巴细胞表面PD-1受体的表达亦呈上调性表达(P<0.05)。随着血管病变的进展,糖尿病患者外周TNF-α和IFN-γ水平呈增加的趋势(P<0.05)。结论 T2DM患者外周单核细胞表面PD-L1表达上调在DM及合并大血管病变、急性冠脉综合症的发生和发展中发挥着一定的作用。
Objective To investigate the expression and biological effects of negative costimulatory molecule-programmed death ligand-1 (PD-L1) on peripheral monocytes in patients with type 2 diabetes mellitus (T2DM) complicated with vascular diseases. Methods The peripheral blood mononuclear cells (PBMCs) were detected by flow cytometry in 42 patients with diabetes mellitus, 48 patients with diabetes mellitus complicated by macrovascular disease, 35 patients with diabetes mellitus with acute coronary syndrome (ACS) and 48 healthy controls The expression of PD-1 on the surface of nucleus and the expression of PD-1 on each T lymphocyte subsets were detected. The levels of tumor necrosis factor-α (TNF-α) ), Γ-interferon (IFN-γ) and other cytokines concentrations. Results Compared with healthy controls, PD-L1 expression in peripheral blood mononuclear cells was significantly increased in all three diabetic patients (P <0.05), and positively correlated with the severity of vascular lesions. The levels of CD4 + and CD8 + T lymphocytes The expression of PD-1 receptor also showed up-regulated expression (P <0.05). With the progression of vascular disease, the levels of TNF-α and IFN-γ in peripheral blood of diabetic patients showed an increasing trend (P <0.05). Conclusion Upregulation of PD-L1 expression on peripheral mononuclear cells in T2DM patients plays an important role in the pathogenesis and progression of DM and macroangiopathy and acute coronary syndrome.