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目的探讨糖皮质激素(简称激素)治疗对系统性红斑狼疮(SLE)患者外周血CD4~+CD25~+T细胞(调节性T细胞)亚群CD62L表达的影响。方法采用流式细胞仪检测了10例初发未经治疗的SLE患者和25例经激素治疗后的SLE患者外周血CD4~+CD25~+T细胞亚群CD62L的表达,并与12例正常人对照组相比较。结果未经治疗的初发SLE患者CD62L~+和CD62L~-的CD4~+CD25~+T细胞均较健康对照组明显减少。激素治疗后,SLE患者外周血CD4~+CD25~+CD62L~+T细胞显著升高,而且与糖皮质激素剂量有关。大剂量激素治疗组CD4~+CD25~+CD62L~+T细胞显著高于未治疗组和正常人对照组,但小剂量激素治疗组CD4~+CD25~+CD62L~+T细胞仅高于未治疗组。然而无论小剂量激素治疗组还是大剂量激素治疗组的CD4~+CD25~+CD62L~-T细胞与正常人对照组比较差异均无统计学意义。SLE患者外周血CD4~+CD25~+CD62L~+ T细胞与疾病活动指数成负相关。结论糖皮质激素可能上调SLE患者外周血CD4~+CD25~+CD62L~+T细胞的生成.促进外周免疫耐受,从而缓解病情。
Objective To investigate the effect of glucocorticoid on the expression of CD62L in peripheral blood CD4 ~ + CD25 ~ + T cells (regulatory T cell) in patients with systemic lupus erythematosus (SLE). Methods Flow cytometry was used to detect the expression of CD62L in CD4 + CD25 + T cell subsets in 10 untreated SLE patients and 25 Hormone-treated SLE patients, and compared with 12 healthy controls Comparison of the control group. Results The percentage of CD4 ~ + CD25 ~ + T cells in untreated SLE patients with CD62L ~ + and CD62L ~ - was significantly lower than that in healthy controls. After hormone therapy, the levels of CD4 ~ + CD25 ~ + CD62L ~ + T cells in peripheral blood of SLE patients were significantly increased, which were also related to the dose of glucocorticoids. The CD4 ~ + CD25 ~ + CD62L ~ + T cells in the high-dose hormone treatment group were significantly higher than those in the untreated group and the normal control group, but the CD4 ~ + CD25 ~ + CD62L ~ + T cells in the low- group. However, there was no significant difference in the CD4 ~ + CD25 ~ + CD62L ~ -T cells between the low-dose hormone treatment group and the high-dose hormone treatment group and the normal control group. The levels of CD4 ~ + CD25 ~ + CD62L ~ + T cells in peripheral blood of SLE patients were negatively correlated with disease activity index. Conclusion Glucocorticoid may up-regulate the production of CD4 ~ + CD25 ~ + CD62L ~ + T cells in peripheral blood of SLE patients, promote peripheral immune tolerance and relieve the disease.