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目的探讨原发性干燥综合征(pSS)患者体内维生素D_3水平与其免疫功能的相关性。方法 36例pSS患者(pSS组)依据SS疾病活动度评分系统(SSDAI)积分对患者进行筛查,活动期(SSDAI积分≥5分)与稳定期(SSDAI积分<5分)各18例,38例健康体检者作为对照组,分别采集外周血,将单个核细胞实施分离,另对CD27+记忆性B细胞及CD27high浆细胞所占比重进行检测;采集血清且对白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及1,25-二羟基维生素D3[1,25(OH)_2D_3]的含量进行检测。结果 pSS组血清中1,25(OH)_2D_3含量低于对照组,差异有统计学意义(P<0.05);pSS活动期患者血清中1,25(OH)_2D_3含量低于稳定期患者,差异有统计学意义(P<0.05)。pSS组血清当中CD27+记忆性B细胞含量及外周血CD27high浆细胞含量低于对照组,差异有统计学意义(t=2.11、15.14,P<0.05)。pSS组血清中TNF-α、IL-17及IL-6含量高于对照组,IL-10含量低于对照组,差异有统计学意义(t=20.40、13.36、14.57、15.21,P<0.05)。pSS活动期患者血清当中的CD27+记忆性B细胞含量及外周血CD27high浆细胞含量均低于稳定期患者,差异有统计学意义(P<0.05)。活动期患者血清中TNF-α、IL-17及IL-6含量均高于稳定期患者,IL-10含量低于稳定期患者,差异有统计学意义(P<0.05)。CD27+记忆性B细胞、IL-10、CD27high细胞含量与1,25(OH)_2D_3含量呈现明显正相关(P<0.05);1,25(OH)_2D_3含量与TNF-α、IL-17及IL-6呈现显著负相关。结论维生素D_3水平异常降低,不仅相关于pSS发病,而且与免疫功能之间存在紧密关联。
Objective To investigate the correlation between vitamin D 3 level and immune function in patients with primary Sjogren’s syndrome (SS). Methods Thirty-six patients with pSS (pSS group) were screened according to the SS Disease Score System (SSDAI) score, 18 patients in active phase (SSDAI score ≥5) and stable phase (SSDAI score <5) Cases of healthy subjects as control group were collected peripheral blood mononuclear cells were isolated, the other on the CD27 + memory B cells and CD27high plasma cells accounted for the proportion of detection; serum was collected and interleukin-17 (IL-17 (IL-10), interleukin-6 (IL-6), tumor necrosis factor-α (TNF- α) and 1,25-dihydroxyvitamin D3 [1,25 (OH) _2D_3] content was detected. Results The serum levels of 1,25 (OH) _2D_3 in pSS group were significantly lower than those in control group (P <0.05). The levels of 1,25 (OH) _2D_3 in patients with pSS active stage were lower than those in stable stage There was statistical significance (P <0.05). The levels of CD27 + memory B cells and peripheral blood CD27high plasma cells in pSS group were lower than those in control group (t = 2.11,15.14, P <0.05). The serum levels of TNF-α, IL-17 and IL-6 in pSS group were significantly higher than those in control group (P 0. 05) . The serum levels of CD27 + memory B cells and peripheral blood CD27high plasma cells in patients with pSS active stage were lower than those in stable stage patients, the difference was statistically significant (P <0.05). The serum levels of TNF-α, IL-17 and IL-6 in patients with active phase were higher than those in stable phase, and the content of IL-10 was lower than that in stable phase (P <0.05). The contents of CD27 + memory B cells, IL-10, CD27high cells and 1,25 (OH) _2D_3 were positively correlated with the levels of TNF-α, IL-17 and IL -6 showed a significant negative correlation. Conclusion The abnormal decrease of vitamin D_3 is not only related to the pathogenesis of pSS but also closely related to immune function.