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目的探讨自身免疫性溶血性贫血(AIHA)患者外周血Th1/Th2、Th3/Tr1细胞状态,分析它们在AIHA发病机制中的作用。方法收集AIHA患者及健康者外周抗凝静脉血,分离纯化淋巴细胞。运用FITC-CD3单抗,Cy5-CD4单抗,PE-CRTH2单抗,以CD3/CD4设门作三色流式细胞术检测Th1/Th2细胞,ELISA法检测血清中Th3细胞相关的细胞因子TGF-β1的含量和Tr1细胞的相关因子IL-10的含量。结果与正常对照相比,AIHA患者外周血CD3+CD4+CRTH2-T细胞(Th1)百分率、CD3+CD4+CRTH2+T细胞(Th2)百分率均下降(P<0.05),而CD4+CRTH2-T/CD4+CRTH2+T比例(Th1/Th2)均明显升高(P<0.01),Th3/Tr1细胞分泌的相关细胞因子TGF-β1和IL-10的含量均降低(P<0.05)。结论AIHA患者外周血存在细胞免疫功能失调,T细胞亚群极化状态发生改变,呈Th1型细胞优势,Th3/Tr1细胞因子含量下降,可能与AIHA的免疫学发病机制有关。
Objective To investigate the status of Th1 / Th2 and Th3 / Th1 cells in peripheral blood of patients with autoimmune hemolytic anemia (AIHA) and analyze their roles in the pathogenesis of AIHA. Methods Peripheral anticoagulation venous blood was collected from AIHA patients and healthy controls, and lymphocytes were isolated and purified. Th1 / Th2 cells were detected by three-color flow cytometry using CD3 / CD4 and FITC-CD3 monoclonal antibody, Cy5-CD4 monoclonal antibody and PE-CRTH2 monoclonal antibody respectively. Serum levels of Th3-related cytokines TGF -β1 and Tr1 cells related factor IL-10 content. Results The percentages of CD3 + CD4 + CRTH2-T cells (Th1) and CD3 + CD4 + CRTH2 + T cells (Th2) in peripheral blood of AIHA patients were significantly lower than those of normal controls (P <0.01). The levels of TGF-β1 and IL-10 secreted by Th3 / Tr1 cells were decreased (P <0.05). Conclusions The peripheral blood cells of AIHA patients have dysfunction of cellular immunity, polarized T cell subsets, altered Th1 type cells and decreased Th3 / Th1 cytokines, which may be related to the immunological pathogenesis of AIHA.