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目的:研究与系统性红斑狼疮(systemic lupus erythematosus,SLE)病理活动相关的调节性T细胞(regulatory T cell,Treg)标志。方法:分离正常人和SLE患者外周血单个核细胞(PBMCs),用三色流式细胞术(flowcytometer,FCM)检测CD4和CD8 T细胞亚群的CD25、Foxp3表达,分析T细胞Foxp3+/CD4+T、CD25+Foxp3+/CD4+、Foxp3+/CD4+CD25+、Foxp3+/CD8+、CD25+Foxp3+/CD8+、及Foxp3+/CD8+CD25+的比值变化,及其与SLE疾病活动指数(SLE disease activity index,SLEDAI)、抗-dsDNA阳性、补体C3/C4水平降低、血清IgG水平增高、肾脏损害、关节病变、白细胞减少、疾病初/复发的关系。结果:①与正常人相比,SLE患者T细胞CD4+CD25+/CD4+比值无明显改变,但中/重度SLE患者外周血T细胞Foxp3+/CD4+、CD25+Foxp3+/CD4+、及Foxp3+/CD4+CD25+比值均显著下降,并与SLEDAI呈负相关;其中CD25+Foxp3+/CD4+比值还与SLE的抗-dsDNA阳性、补体C3/C4水平降低、血清IgG水平增高相关,在疾病初发、肾脏损害、白细胞减少患者该比值下降更为显著;②SLE患者CD8+T细胞中CD25+、Foxp3+亚群比例未见明显减少,仅中/重度活动性SLE患者Foxp3+/CD8+CD25+比例减少,但与SLEDAI无相关性。结论:以CD25+Foxp3+作为Treg标志,可以明显反映出SLE患者CD4+Treg存在数量缺陷,并与疾病活动性、免疫功能紊乱和病理损害密切相关,故将CD4+CD25+Foxp3+作为标志进行Treg检测对辨明SLE患者免疫系统功能状态具有一定的临床参考价值。
Objective: To investigate the regulatory T cell (Treg) markers associated with the pathological activity of systemic lupus erythematosus (SLE). Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from normal and SLE patients. CD25 and Foxp3 expression in CD4 and CD8 T cell subsets were detected by flowcytometer (FCM). The expressions of Foxp3 + / CD4 + T, CD25 + Foxp3 + / CD4 +, Foxp3 + / CD4 + CD25 +, Foxp3 + / CD8 +, CD25 + Foxp3 + / CD8 + and Foxp3 + / CD8 + CD25 +, and their relationship with SLE disease activity index Anti-dsDNA positive, C3 / C4 levels of complement reduction, elevated serum IgG levels, kidney damage, joint disease, leukopenia, early / recurrence of the disease. Results: ① There was no significant difference in CD4 + CD25 + / CD4 + ratio of T cells in SLE patients compared with normal controls. However, the ratio of Foxp3 + / CD4 +, CD25 + Foxp3 + / CD4 + and Foxp3 + / CD4 + CD25 + , Which was negatively correlated with SLEDAI. The ratio of CD25 + Foxp3 + / CD4 + also correlated with anti-dsDNA positive of SLE, decreased level of complement C3 / C4 and elevated serum IgG level. In the initial stage of disease, renal damage and leucopenia The ratio of CD25 + and Foxp3 + in SLE patients was significantly lower than that in SLE patients. (2) The proportion of Foxp3 + / CD8 + CD25 + in SLE patients with SLE only decreased but not with SLEDAI. Conclusion: Using CD25 + Foxp3 + as a marker of Treg can clearly reflect the number of CD4 + Tregs in SLE patients and is closely related to disease activity, immune dysfunction and pathological damage. Therefore, CD4 + CD25 + Foxp3 + SLE patients to identify the functional status of the immune system has some clinical reference value.