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目的探讨MG患者外周血FOXP3、TGF-β1及AChR抗体三者之间的关系,揭示MG的发病机制。方法利用RT-PCR技术检测41例MG患者和20例体检健康者外周血单个核细胞FOXP3 mRNA的表达,ELISA技术检测外周血清TGF-β1浓度、抗AChR抗体水平,分析三者之间的关系。结果(1)FOXP3 mRNA的表达水平在MG患者组明显低于正常对照组(P<0.01),在25例眼肌型患者与16例全身型患者中的表达无差异性(P>0.05);(2)MG患者组外周血清TGF-β1浓度在MG患者组明显低于正常对照组(P<0.01),但在25例眼肌型患者与16例全身型患者中的表达无差异性(P>0.05);(3)41例MG患者中有30例患者血清中可检测出IgG型AChR抗体,其中眼肌型18例,全身型12例,两亚型的AChR抗体阳性率和抗体水平无显著差异(P>0.05);(4)各组外周静脉血单个核细胞FOXP3 mRNA的表达与血清TGF-β1浓度成正相关,相关系数为0.84(P<0.01);与IgG型AChR抗体水平呈负相关,相关系数为-0.77(P<0.01);血清TGF-β1浓度与IgG型AChR抗体水平呈负相关,-0.81(P<0.01)。结论FOXP3mRNA、TGF-β1低表达可能通过增加AChR抗体的产生,在MG的发病中起到重要作用。
Objective To investigate the relationship between FOXP3, TGF-β1 and AChR in peripheral blood of patients with MG and to reveal the pathogenesis of MG. Methods The expression of FOXP3 mRNA in peripheral blood mononuclear cells of 41 patients with MG and 20 healthy controls were detected by RT-PCR. The levels of TGF-β1 in serum and levels of anti-AChR antibody in peripheral blood were detected by ELISA, and the relationship among them was analyzed. Results (1) The expression of FOXP3 mRNA in MG patients was significantly lower than that in normal controls (P <0.01). There was no difference in the expression of FOXP3 mRNA in 25 patients with ocular muscle and 16 patients with systemic disease (P> 0.05). (2) The serum TGF-β1 level in peripheral blood of patients with MG was significantly lower than that of the normal control group (P <0.01), but there was no difference in the expression of TGF-β1 in 25 patients with ocular muscle and 16 patients with systemic disease > 0.05). (3) IgG antibodies against AChR were detected in sera of 30 patients with MG, of which 18 were ocular and 12 were systemic. The positive rate of AChR and the antibody level of two subtypes (P> 0.05). (4) The expression of FOXP3 mRNA in peripheral blood mononuclear cells of each group was positively correlated with the concentration of serum TGF-β1, the correlation coefficient was 0.84 (P <0.01) The correlation coefficient was -0.77 (P <0.01). The serum concentration of TGF-β1 was negatively correlated with the IgG antibody level of AChR (-0.81, P <0.01). Conclusion The low expression of FOXP3 mRNA and TGF-β1 may play an important role in the pathogenesis of MG by increasing the production of AChR antibody.