糖皮质激素对重症肌无力患者外周血调节性T细胞中Foxp3及其胞内CTLA-4表达的影响

目的 研究糖皮质激素治疗重症肌无力( MG)患者外周血CD4 +CD25 +调节性 T 细胞( Treg )中 Foxp3 和胞内CTLA-4的表达水平的变化. 方法 收集MG患者34例,分为非治疗组8例和糖皮质激素治疗组26 例. 另将20 例健康者设为对照组. 采用流式细胞仪检测分析患者和健康者外周血CD4 +CD25 +Treg细胞Foxp3和胞内CTLA-4的变化.结果 ① MG非治疗组患者外周血 CD4 +CD25 +Treg细胞Foxp3和胞内CTLA-4水平较对照组显著下降( P<0. 05 );②糖皮质激素治疗能显著提升CD4 +CD25 +Treg细胞Foxp3和胞内CTLA-4表达比例( P <0. 05 ) ,但仍低于对照组( P <0. 05);③ CD4 +CD25 +Treg细胞Foxp3和胞内CTLA-4表达呈正相关性(r=0. 870,P<0. 001). 结论 MG患者外周血CD4 +CD25 +Treg Foxp3和胞内CTLA-4呈低表达,糖皮质激素治疗能显著提升Foxp3和胞内CTLA-4表达水平,但尚未达正常者免疫状态.

Expression alteration of Foxp3 and intracellular CTLA-4 of regulatory T cells in peripheral blood of myasthenia gravis patients under glucocorticoids treatment

Objective To study the expression alteration of Foxp3 and intracellular CTLA-4 of CD4 +CD25 +regula-tory T cells in peripheral blood of myasthenia gravis patients under glucocorticoids treatment. Methods 34 patients with myasthenia gravis were selected, and subgrouped with no treatment group(8 cases) or glucocorticoids treat-ment group(26 cases) . Another 20 healthy subjects were set as the control group. 6-color flow cytometry was used to analyze the expression of Foxp3 and intracellular CTLA-4 of CD4 +CD25 + regulatory T cells in their peripheral blood of participants. Results ①Compared with the control group, the level of Foxp3 and intracellular CTLA-4 of CD4 +CD25 +regulatory T cells in peripheral blood of in no treatment group were significantly decreased ( P <0. 05 ) . ② the level of Foxp3 and intracellular CTLA-4 of CD4 +CD25 +regulatory T cells in peripheral blood of pa-tients with glucocorticoids treatment group were significantly higher than that of no treatment group(P<0. 05), but were still lower than that of the control group(P<0. 05). ③Foxp3 expression was positively correlated with intra-cellular CTLA-4 expression in CD4 +CD25 +regulatory T cells of patients with myasthenia gravis ( r=0. 870 , P<0. 001 ) . Conclusion Low expression of Foxp3 and intracellular CTLA-4 of CD4 +CD25 + regulatory T cells in pe-ripheral blood is present in patients with myasthenia gravis, glucocorticoids could significantly increase the expres-sion of Foxp3 and intracellular CTLA-4, however, which still do not reach the immune state of healthy subjects.