类风湿性关节炎的发生发展与外周血T淋巴细胞亚群及CD4+TH1/TH2细胞功能亚型的关系

背景类风湿性关节炎作为一种自身免疫病其免疫学发病机制目前尚未完全明确.T淋巴细胞、尤其是CD4+ TH1/TH2细胞在类风湿性关节炎发生发展中可能有重要作用.目的探讨主要参与细胞免疫的CD4+ TH1细胞和辅助体液免疫应答的TH2细胞在类风湿性关节炎发生发展过程中的作用.设计病例-对照,对比观察.单位武警医学院免疫学教研室.对象选择1999-03/2000-03在天津医科大学总医院内科就诊的类风湿性关节炎患者15例为患者组,男2例,女13例,其中12例受检者类风湿因子阳性,3例为阴性.同期选取健康体检者或本单位工作人员健康者30人为对照组,男4人,女26人.纳入对象均对实验目的知情同意.方法①采用酶联免疫斑点法对两组对象的外周血单个核细胞中CD3+T细胞(总T细胞)、CD4+T细胞和CD8+T细胞进行检测,普通光学显微镜油镜下计数200～500个淋巴细胞,计算出阳性细胞的百分率.②采用酶联免疫斑点法检测活化的分泌细胞因子的TH细胞;细胞内有红色斑点的细胞为阳性细胞,分泌γ-干扰素的细胞为TH1细胞,分泌白细胞介素4的细胞为TH2细胞;普通光学显微镜油镜下计数200～500个淋巴细胞,计算出TH1细胞、TH2细胞的百分率及TH1/TH2细胞的比值.③采用t检验或x2检验比较数据间差异性.主要观察指标两组对象外周血T淋巴细胞亚群(包括CD3+T细胞、CD4+T细胞、CD8+T细胞)及CD4+TH1/TH2细胞定量分析结果.结果类风湿性关节炎患者15例和健康者30人均进入结果分析.①两组外周血的总T细胞(即CD3+T细胞)、CD4+T细胞及CD8+T细胞的百分率差异不明显(P＞0.05).②患者组外周血的TH1细胞的百分率明显高于对照组(24.44±5.25)%,(14.93±3.82)%,P＜0.05];而其外周血TH2细胞的百分率及TH1/TH2细胞的比值与对照组相近(P＞0.05).结论TH1细胞介导的细胞免疫可能与类风湿性关节炎的发生发展有关.

Relationship of the occurrence and development of rheumatism arthritis with T lymphocyte subsets and CD4+ TH1/TH2 cell functional subsets

BACKGROUND: Rheumatoid arthritis(RA) is an autoallergic disease,but its immunological pathogenesis has not been completely known. T lymphocytes, especially CD4+ TH1/TH2 cells, may have an important effect in the occurrence and development of RA.OBJECTIVE: To investigate the action of CD4+ TH1 and TH2 cells which separately mediate cellular immunity and humoral immunologic response (respectively) function in the occurrence and development of RA.DESIGN: Case-control, comparative observation.SETTING: Department of Immunology, Medical College of Chinese People's Armed Police Forces.PARTICIPANTS: Totally 15 patients with RA hospitalized in the Department of Internal Medicine of General Hospital of Tianjin Medical University between March 1999 and March 2000 were selected for a RA patient group, consisting of 2 males and 13 females. Of them, 12 patients whose serumal rheumatoid factor (RF)was positive and the three others' was negative. At the same time, 30 healthy individuals from persons receiving health examination in the hospital or from our department were selected for a healthy control group, consisting of 4 males and 26 females. Informed consents were obtained from the participants.peripheral blood mononuclear cells(PBMC) from the two groups of subjects were detected by enzyme-linked immunospot assay (ELISPOT). 200-500 lymphocytes were counted under a normal light microscope, and the perwhich secreted cytokines were detected by ELISPOT, and those which had red spots in their plasma after staining were positive cells. Among them,the cells secreting γ-interferon (IFN-γ) were Tm cells while those secreting interleukin-4 (IL-4) were TH2 cells. 200-500 lymphocytes were counted under a normal light microscope and the percentages of TH1 and TH2 cells square test were used for comparing statistical differences of data between the two groups.MAIN OUTCOME MEASURES: Quantitative analysis of T lymphocyte subsets (including CD3+ T cells, CD4+ T cells and CD8+ T cells) and CD4+ TH1/TH2 cells in peripheral blood from the two groups of subjects.RESULTS: Analysis of the results was from the study on all of subjects percentages of total T cells (CD3+ T cells), CD4+T cells and CD8+F cells in peripheral blood were not significantly different between the two significantly higher in RA patient group than that in healthy control group (24.44±5.25)%, (14.93±3.82)%, P ＜ 0.05],while in RA patient group the percentage of TH2 cells and ratio of TH1 cells to TH2 cells from peripheral blood were not significantly different as compared with those of control group(P ＞ 0.05).CONCLUSION: Cellular immunologic function mediated by TH1 cells may be associated with the occurrence and development of RA.