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目的探讨共刺激分子表达水平在系统性红斑狼疮(SLE)患者治疗前后的变化及其意义。方法采用免疫荧光标记流式细胞仪检测技术,对SLE患者和正常人外周血单个核细胞膜表面的共刺激分子表达水平进行测定分析。结果①与正常人相比,SLE患者CD28分子表达显著降低(P<0.01),其中双标记CD4+CD28+、CD8+CD28+T细胞均显著减少(P<0.01),4-1BB分子表达显著增高(P<0.01);②患者CD28分子、CD4+CD28+及CD8+CD28+T细胞与SLE病情活动指数(SLEDAI)呈负相关(分别为P<0.01、P<0.01、P<0.05),4-1BB分子与SLEDAI呈正相关(P<0.01);③患者治疗后CD28分子、CD4+CD28+及CD8+CD28+T细胞随病情缓解而上升(P<0.01),4-1BB分子随病情缓解而下降(P<0.01)。结论共刺激分子表达异常在SLE发病机制中可能具有重要作用,其中CD28分子、4-1BB分子、CD4+CD28+及CD8+CD28+T细胞对监测病情活动和判断疗效可能具有重要意义。
Objective To investigate the changes of costimulatory molecules in patients with systemic lupus erythematosus (SLE) before and after treatment and its significance. Methods The expression of costimulatory molecules on the surface of mononuclear cells in peripheral blood mononuclear cells from patients with SLE and normal controls were determined by immunofluorescence labeling and flow cytometry. Results ① Compared with normal controls, the expression of CD28 in SLE patients was significantly decreased (P <0.01), and the number of double-labeled CD4 + CD28 + and CD8 + CD28 + T cells was significantly decreased (P <0.01) (P <0.01). ② The levels of CD28, CD4 + CD28 + and CD8 + CD28 + T cells were negatively correlated with SLEDAI (P <0.01, P <0.01, 1BB molecule was positively correlated with SLEDAI (P <0.01) .③The numbers of CD28, CD4 + CD28 + and CD8 + CD28 + T cells increased with the progression of disease (P <0.01) P <0.01). Conclusion The abnormal expression of co-stimulatory molecules may play an important role in the pathogenesis of SLE. CD28, 4-1BB, CD4 + CD28 + and CD8 + CD28 + T cells may play an important role in monitoring disease activity and judging the therapeutic effect.