系统性红斑狼疮患者外周血调节性T细胞、Foxp3和IL-6的表达

目的探讨系统性红斑狼疮（ systemic lupus erythematosus, SLE）患者外周血CD4^＋ CD25^＋调节性T细胞（regulatory T cells,Tregs）、roxp3 mRNA和血浆IL-6表达的意义。方法对38例SLE患者和16例正常人采用流式细胞术检测外周血CD4^＋ CD25^＋ T regs百分率,RT-PCR检测roxp3 mRNA表达,ELISA法检测IL-6水平。结果①SLE活动组和非活动组的CD4^＋ CD25^＋ Tregs水平均显著低于正常对照组（P〈0．01）;②SLE活动组的roxp3 mRNA表达水平明显低于正常对照组（P〈0．05）;③SLE活动组和非活动组血浆的IL-6水平均显著高于正常对照组（P〈0．01）,而且活动组显著高于非活动组（P〈0．05）;④38例SLE患者的CD4^＋ CD25^＋Tregs水平与SLEDAI评分呈显著性负相关（P〈0．01）,F0xp3mRNA水平与CD4^＋ CD25^＋Tregs呈显著性正相关（P〈0．01）,血浆IL-6水平与SLEDAI评分之间呈显著性正相关（P〈0．01）,血浆IL-6水平与CD4^＋ CD25^＋Tregs／CD4^＋细胞比值呈显著负相关（P〈0．05）。结论CD4^＋ CD25^＋Tregs和Foxp3以及IL-6可能在SLE的发生和发展中发挥重要作用。     

双歧杆菌对肠上皮细胞生长和白介素-8分泌功能的影响

目的探讨双歧杆菌对人肠上皮细胞株HT29生长及其IL-8分泌水平的影响。方法HT29细胞在96孔板上生长24h后分为正常细胞对照组、高剂量双歧杆菌共培养组（细菌终浓度为1×10^10CFU／m1）、低剂量双歧杆菌共培养组（细菌终浓度为1×10^6CFU／ml）、轮状病毒感染对照组,分别加入不同剂量双歧杆菌和感染轮状病毒共培养,继续培养24h,光镜下观察细胞生长状态,MTT比色法检测细胞活性情况,ELISA检测细胞培养上清中IL-8表达水平。结果光镜下观察到双歧杆菌与HT29细胞共培养后细胞形态无明显改变,共培养24h后MTT检测双歧杆菌对HT29细胞增殖和调亡无明显影响,但轮状病毒感染对照组细胞病变脱落,活细胞数量明显减少。共培养6h,其余3组细胞培养上清中IL-8分泌较正常细胞对照组增加（P〈0．05）,高剂量双歧杆菌组增加较低剂量双歧杆菌组差异有显著性（P〈0．05）,但两个剂量组均明显低于轮状病毒感染阳性对照组的IL-8分泌增加水平（P〈0．05）;感染后24h,细胞培养上清中IL-8分泌水平高于正常细胞对照组（P〈0．05）,但高、低剂量双歧杆菌组之间差异无显著性（P〉0．05）,两个剂量组IL-8分泌增加水平均明显低于轮状病毒感染阳性对照组（P〈0．01）。结论两歧双歧杆菌共培养不影响HT29细胞的生长,双歧杆菌能够促进HT29细胞分泌细胞因子IL-8,但明显低于致病微生物刺激引起的细胞因子分泌水平改变,这种促进作用无时间-剂量依赖关系,提示双歧杆菌与肠道内致病微生物对肠道免疫功能的影响不同,双歧杆菌促进肠上皮细胞分泌IL-8可能与其参与的肠道黏膜免疫系统发育成熟相关。     

妊娠高血压外周血中促Th2的细胞因子水平及IL-2／IL-10平衡的临床意义

目的：检测妊娠高血压患者外周血中促Th2的分子IL-4、IL-2与IL-10的水平,探讨IL-2／IL-10在妊高症中的临床意义。方法：选择40例未妊娠妇女为对照组,30例正常妊娠妇女为妊娠组,28例妊娠高血压患者为妊娠高血压组,ELISA检测血清中IL-4、IL-2和IL-10的水平。结果：与对照组外周血中IL-4水平（0．53±0．04）pg／ml相比：正常妊娠组IL-4水平升高至（0．91±0．03）pg／ml（P〈0．05）,妊娠高血压组IL-4水平（0．67±0．35）pg／ml升高但明显低于正常妊娠组（P〈0．01）。与对照组外周血中IL-2水平（0．41±0．05）pg／ml相比：正常妊娠组IL-2水平升高至（0．82±0．11）pg／ml（P〈0．01）;妊娠高血压组IL-2水平高达1．57±0．22（pg／m1）明显高于其它两组（P〈0．01）。妊娠高血压组外周血中IL-10水平明显低于正常妊娠组IL-10水平（P〈0．01）;妊娠高血压组外周血中IL-2／IL-10比值明显高于于对照组及正常妊娠组的比值。结论：妊娠高血压患者外周血中细胞因子IL-2和IL-10分泌异常且诱导Th2细胞产生的IL-4降低,打破Th1／Th2平衡,致使Th1型免疫反应增强,使早孕期滋养细胞受到免疫损伤以致侵入能力下降,导致妊娠期高血压疾病的发生。     

地佐辛超前镇痛对全膝关节置换术患者围术期细胞因子的影响

目的：探讨地佐辛超前镇痛对全膝关节置换术患者围术期白介素-6（IL-6）、白介素-8（m-8）和肿瘤坏死因子-α（TNF-α）浓度的影响。方法：40例择期行单侧全膝关节置换术患者,随机分为超前镇痛组（实验组）和术后镇痛组（对照组）,每组20例。均采用蛛网膜下腔麻醉,患者静脉自控镇痛（PCIA）：地佐辛0．8mg／kg,生理盐水稀释至100mL。负荷剂量：5mL,持续剂量：2mL／h,追加剂量：0．5mL／次,锁定时间：15min。实验组于入室后10分钟麻醉操作前开始静脉负荷量和背景量,对照组于术毕开始PCIA镇痛,方法同实验组,记录患者术后6、8、12、24小时的疼痛视觉模拟评分（VAS评分）以及术后48小时内患者恶心呕吐的发生情况,于入室后10分钟麻醉操作前（T1）、手术开始后10分钟（T2）、术毕2h（T3）、4h（T4）、8h05）、24h（T6）时间点抽取静脉血样,测定细胞因子IL-6、IL-8、TNF-α水平。结果：术后6h、8h、12h时间点VAS评分实验组较对照组明显降低（P〈0．05）,24hVAS评分变化不大,无统计学差异（P〉0．05）。术后48小时内,实验组发生恶心呕吐1例,对照组2例。与本组T1比较,血浆IL-6、IL．8浓度实验组在各时点变化不大,无统计学差异（P〉0．05）,对照组浓度升高（P〈0．05）。组间比较,相同时点血浆IL-6、IL-8浓度实验组均低于对照组（P〈0．05）。两组血浆TNF-α浓度比较差异无统计学意义（P〉0．05）。结论：全膝关节置换术术前预先给予地佐辛可产生良好的超前镇痛效果,减少患者围术期细胞因子的产生。     

变应性鼻炎患者外周血中IL-27和Treg细胞的相关性分析

目的探讨外周血IL-27和CD4^＋CD25^＋调节性T细胞（Treg）在变应性鼻炎（AR）发病机制中的作用。方法2012年3月至7月,收集AR患者32例（AR组）和20例健康志愿者（对照组）外周血,采用流式细胞术（FCM）检测外周血中Treg细胞比例;ELISA检测血清中IL-27、IL-10和TGF-β1的水平。结果AR组Treg细胞百分率[（1．75±0．56）％]明显低于对照组[（4．76±1．75）％],两组比较的差异有统计学意义（P〈0．01）。AR组IL-27、IL-10和TGF-β1的水平分别为（24．43±16．36）pg／ml、（14．29±6．16）pg／ml、（0．34±0．04）pg／ml,均低于对照组（44．09±13．12）pg／ml、（31．32±21．20）pg／ml、（O．49±0．06）pg／ml,两组之间的差异有统计学意义（P〈0．01）。AR患者外周血中IL-27和Treg细胞百分率、IL-10、TGF-β1存在正相关（r分别为0．825,0．646,0．517,P〈0．01）,Treg细胞百分率和IL-10、TGF-β1存在正相关（r=0.622,0．738,P〈0．01）,IL-10和TGF-β1无相关性（r=0．304,P〉0．05）结论AR患者外周血中IL-27水平降低,Treg细匏百分率降低及其主要分泌因子IL-10、TGF-β1水平降低,且IL-27与Treg细胞百分率、IL-10、TGF-β1水平呈正相关,提示在AR发病中IL-27对Treg细胞可能具有免疫调节作用。     

碳酸酐酶IV自身抗体在慢性心力衰竭患者中的测定

目的：对慢性心力衰竭（CHF）患者血清中的抗碳酸酐酶IV自身抗体、抗氧化物及细胞因子的水平进行检测。方法：选取CHF患者共73例,测定其血清抗碳酸酐酶IV自身抗体、血沉、SOD等6种抗氧化物和IL-6等4种细胞因子的水平。结果：CHF患者血清抗碳酸酐酶IV自身抗体水平显著高于健康对照组（P〈0．05）,SOD、GPx、CAT和TAC水平显著低于健康对照组（P〈0．05）,MDA水平显著高于对照组（P〈0．05）。CHF患者血清的IL-2水平较健康对照组显著升高（P〈0．05）,IL-3、IL-17、IFN-α和IFN-γ与健康对照组无显著性差异（P〉0．05）。结论：CHF患者血清抗氧化物水平和几．2的变化可能参与了其体内碳酸酐酶Ⅳ抗体的产生。     

KI对l染铅近曲肾小管上皮细胞I A 表达及凋亡的影响

目的：研究碘化钾对染铅肾小管上皮细胞XIAP的表达及凋亡的影响,探讨其对抵抗铅导致的近曲肾小管上皮细胞损伤的可能机制。方法：应用流式细胞术检测染铅HK-2细胞及对照组细胞中XIAP的表达及凋亡情况。结果：染铅HK-2细胞中XIAP的表达明显低于对照组,且虽然铅浓度的增高而降低（P〈0．05／P〈0．01）,碘化钾能够减弱上述变化（P〈0．05／P〈0．01）;染铅HK-2细胞的凋亡率明显高于对照组,且虽然铅浓度的增高而升高（P〈0．05／P〈0．01）,碘化钾能够降低染铅细胞的凋亡率（P〈0．05／P〈0．01）。结论：碘化钾能够上调染铅HK-2细胞中抗凋亡蛋白XIAP的表达,降低凋亡率,在一定程度上降低铅对细胞的损伤。     

血β2微球蛋白水平在系统性红斑狼疮中的临床意义

目的：探讨系统性红斑狼疮（systemic lupus erythematosus,SLE）患者血β2-MG水平与疾病活动的相关性及其临床意义。方法：随机抽取2012年2月-2012年7月我科收治的62例SLE患者（SLE组）和同期在我院门诊体检的健康体检者40例（对照组）,检测和比较两组血清β2-MG、自身抗体、补体水平,并对SLE患者进行SLEDAI评分,分析SLE患者血清β2-MG水平与自身抗体、补体水平和SLEDAI评分的相关性。结果：SLE组血β2-MG水平（3．11±0．40μg／mL）显著高于对照组（2．23±0．23μg/mL）,差异有统计学意义（P〈0．05）;其中发生口腔溃疡、浆膜炎及蛋白尿的SLE患者的血β2-MG水平与无此三种表现的患者相比显著升高,差异有统计学意义（P〈0．05）。SLE患者的血β2-MG水平与抗ds—DAN抗体、SLEDAI均呈显著正相关（分别为r=0．289,r=0．361,P〈0．01）,与C3呈负相关（r=-0．271,P〈0．05）。结论：SLE患者血β2-MG水平高于正常,可作为SLE疾病活动指标用于监测疾病活动。     

γ射线对人淋巴细胞cx43和ANLN基因转录表达的影响

目的研究γ射线对人外周血淋巴细胞cx43和ANLN基因转录表达的影响。方法对数生长期的淋巴细胞,分别给予1、2、3、4、5、6 Gy的^60Coγ射线照射,照射后12h,以及2Gy照射后4、8、12、24、36、48、72h,分别提取总RNA,反转录成cDNA。利用实时荧光定量PCR技术,检测各组cx43和ANLN基因表达改变。结果人外周血淋巴细胞cx43 mRNA表达水平在2Gy照射后4、8、12h明显增高,分别为对照组（未照射组）的6．74、9．06、7．22倍（P〈0．05）;24～72h,其表达水平与对照组相比没有明显变化。1、2、3、4、5、6Gy剂量照射后12h,cx43 mRNA表达水平显著增高（P〈0．05）。ANLN mRoNA表达水平在2Gy不同时间点及1～5Gy照射后12h,表达降低（P〈0．05）,6Gy照射后12h其表达开始升高,为对照组的6．08倍（P〈0．05）。结论γ射线照射2Gy不同时间点及不同剂量照射后12h,cx43基因表达上调,ANLN基因表达下调。1～3Gy剂量照射后12h,cx43 mRNA表达在此范围内有时间和剂量的依赖性。cx43可能会发展为核事故受照射人员的分子生物学剂量标记物。     

不同镇痛方法对患者IL-6、IL-8、IL-10的影响

目的评价不同镇痛方法对盆腔手术患者血浆中细胞因子变化的影响,并与传统术后镇痛法进行比较,探讨术后充分镇痛对免疫功能的影响。方法根据镇痛方法不同,将60例行子宫切除患者随机分为3组：第1组患者为术后根据临床需要,临时给予哌替啶50mg肌肉注射（Ⅰ组,n=20）;第Ⅱ组患者为罗哌卡因复合芬太尼硬膜外镇痛组（Ⅱ组,n=20）;第Ⅲ组患者为芬太尼静脉镇痛组（Ⅲ组,n=20）;观察麻醉前30min、手术后30min、2h、24h、48h和72h六个时点患者血清中白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-10（IL-10）水平的变化。结果3组患者术后血清IL-6、IL-8、IL-10水平与麻醉前值比较均升高（P〈0．01）,一般在术后24h达峰值。比较血清IL-6、IL-8、IL-10浓度变化,Ⅱ和Ⅲ组抑制这3种细胞因子释放的能力明显强于Ⅰ组（P〈0．05）,与Ⅲ组比较,Ⅱ组更为明显（P〈0．05）。结论硬膜外局麻药复合阿片受体激动药镇痛模式可更有效地降低术后炎性直激反应。     

Patients with systemic lupus erythematosus have abnormally elevated Epstein-Barr virus load in blood

Various genetic and environmental factors appear to be involved in systemic lupus erythematosus (SLE). Epstein-Barr virus (EBV) is among the environmental factors that are suspected of predisposing to SLE, based on the characteristics of EBV itself and on sequence homologies between autoantigens and EBV antigens. In addition, higher titers of anti-EBV antibodies and increased EBV seroconversion rates have been observed in SLE patients as compared with healthy control individuals. Serologic responses do not directly reflect EBV status within the body. Clarification of the precise status of EBV infection in SLE patients would help to improve our understanding of the role played by EBV in this disease. In the present study we determined EBV types in SLE patients (n = 66) and normal control individual (n = 63) by direct PCR analysis of mouthwash samples. We also compared EBV load in blood between SLE patients (n = 24) and healthy control individuals (n = 29) using semiquantitative PCR assay. The number of infections and EBV type distribution were similar between adult SLE patients and healthy control individuals (98.5% versus 94%). Interestingly, the EBV burden in peripheral blood mononuclear cells (PBMCs) was over 15-fold greater in SLE patients than in healthy control individuals (mean +/- standard deviation: 463 +/- 570 EBV genome copies/3 microg PBMC DNA versus 30 +/- 29 EBV genome copies/3 microg PBMC DNA; P = 0.001), suggesting that EBV infection is abnormally regulated in SLE. The abnormally increased proportion of EBV-infected B cells in the SLE patients may contribute to enhanced autoantibody production in this disease.     

Cytokine regulation of apoptosis and Bcl-2 expression in lymphocytes of patients with systemic lupus erythematosus

Both faulty regulation of apoptosis and the inappropriate expression of several interleukins have been considered important defects of lymphocytes in the human autoimmune disease systemic lupus erythematosus (SLE). We therefore tested the in vitro effect of recombinant interleukin (IL-)-2, 4, 7, and 15 on peripheral blood mononuclear cells from patients with SLE and from healthy volunteers. Intracellular Bcl-2 and Bax expression was measured by fluorocytometry and the rate of apoptosis was determined by the TUNEL technique and propidium iodide staining. IL-2, IL-4, IL-7 and IL-15 led to a significant increase in Bcl-2 and a reduction in cell death rates, which was even more pronounced in SLE. Bax levels remained unchanged. Interestingly, the high ex vivo Bcl-2 content of lymphocytes from some SLE patients was maintained after growth factor withdrawal. Anti-apoptotic cytokine signaling may significantly influence the deregulation of cell death in SLE lymphocytes.     

Lymphocyctes Tgammadelta in clinically normal skin and peripheral blood of patients with systemic lupus erythematosus and their correlation with disease activity

Human Tgammadelta lymphocytes constitute from 1 to 15% of all peripheral blood lymphocytes. Recent work has demonstrated that this population plays a major role in the pathogenesis of infectious and immune diseases. Increased numbers of gammadelta T cells have been found in affected skin from systemic sclerosis and chronic cutaneous lupus erythematosus patients. In our study, we have determined the numbers of Tgammadelta lymphocytes and their subpopulations in peripheral blood from 29 patients with systemic lupus erythematosus (SLE) and in 19 healthy volunteers using flow cytometry and specific monoclonal antibodies. The same cells in uninvolved skin from SLE patients and human controls using immunohistochemical analysis were estimated. T-Cell receptor (TCR) delta chain gene rearrangement was identified with primers for Vdelta1, Vdelta2 and Vdelta3 by the polymerase chain reaction. Statistical analysis showed a significantly decreased number of gammadelta T cells in SLE patients (26.4+/-16.9/microl) compared with the control group (55.3+/-20.6/microl (p < 0.001). The number of Vdelta2 TCR+ and Vgamma9 TCR+ subpopulations was also lower in SLE patients than in healthy persons. No statistical correlation between disease activity and the number of gammadelta T cells was demonstrated. The percentage of Tgammadelta lymphocytes in clinically normal skin from SLE patients was twice (22.0+/-9.4%) that found in the skin from healthy persons (11.1+/-5.5%) (p < 0.002). Higher percentages of the Vdelta2 TCR+ and Vgamma9 TCR+ subpopulation of lymphocytes were found in the skin from SLE patients. We have also found positive correlation between the percentage of Tgammadelta lymphocytes in skin and the activity of SLE (r=0.594, p < 0.001), and between subpopulation Vdelta3 TCR+ and disease activity (r=0.659, p< 0.001). In conclusion, the results of our studies demonstrate that, in patients with SLE, accumulation of Tgammadelta lymphocytes can be seen in clinically normal skin, and the percentage of these cells correlates with the activity of the disease.     

Patients with systemic lupus erythematosus have abnormally elevated Epstein–Barr virus load in blood

Various genetic and environmental factors appear to be involved in systemic lupus erythematosus (SLE). Epstein–Barr virus (EBV) is among the environmental factors that are suspected of predisposing to SLE, based on the characteristics of EBV itself and on sequence homologies between autoantigens and EBV antigens. In addition, higher titers of anti-EBV antibodies and increased EBV seroconversion rates have been observed in SLE patients as compared with healthy control individuals. Serologic responses do not directly reflect EBV status within the body. Clarification of the precise status of EBV infection in SLE patients would help to improve our understanding of the role played by EBV in this disease. In the present study we determined EBV types in SLE patients (n = 66) and normal control individual (n = 63) by direct PCR analysis of mouthwash samples. We also compared EBV load in blood between SLE patients (n = 24) and healthy control individuals (n = 29) using semiquantitative PCR assay. The number of infections and EBV type distribution were similar between adult SLE patients and healthy control individuals (98.5% versus 94%). Interestingly, the EBV burden in peripheral blood mononuclear cells (PBMCs) was over 15-fold greater in SLE patients than in healthy control individuals (mean ± standard deviation: 463 ± 570 EBV genome copies/3 μg PBMC DNA versus 30 ± 29 EBV genome copies/3 μg PBMC DNA; P = 0.001), suggesting that EBV infection is abnormally regulated in SLE. The abnormally increased proportion of EBV-infected B cells in the SLE patients may contribute to enhanced autoantibody production in this disease.     

Elevation of human tumor necrosis factor-like weak inducer of apoptosis in peripheral blood mononuclear cells is correlated with disease activity and lupus nephritis in patients with systemic lupus erythematosus

Tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) is a recently identified proinflammatory cytokine of the TNF superfamily. Studies have indicated that TWEAK plays an important role in renal, vascular injury and immune disease. The aim of this study was to explore the expression of the TWEAK in peripheral blood mononuclear cells (PBMCs) and analyze the correlation between TWEAK and disease activity and renal damage of SLE. The expression of TWEAK in PBMCs was determined by RT-PCR and western blot. SLE disease activity was evaluated by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) 2000 score. Next were analyzed the correlations of TWEAK mRNA and protein to serum IL-10, MCP-1 and some laboratory parameters of SLE disease activity. Subjects comprised 48 patients with SLE including 25 patients with renal damage and 23 without, 20 patients with rheumatoid arthrithis (RA) and 15 healthy controls. The results showed that TWEAK expressions in PBMCs from SLE patients were significantly higher than that in RA patients or healthy controls, especially higher in those patients with renal disease. Elevated production of TWEAK is correlated positively and significantly with SLEDAI, proteinuria, serum anti-dsDNA, IL-10 and MCP-1, but inversely associated with serum complements. Our results suggested that TWEAK in PBMCs is positively related to SLE disease activity and might be involved in the pathogenesis of SLE.     

Altered expression of protein tyrosine phosphatase,non-receptor type 22 isoforms in systemic lupus erythematosus

Introduction

A C-to-T single nucleotide polymorphism (SNP) located at position 1858 of human protein tyrosine phosphatase, non-receptor type 22 (PTPN22) complementary DNA (cDNA) is associated with an increased risk of systemic lupus erythematosus (SLE). How the overall activity of PTPN22 is regulated and how the expression of PTPN22 differs between healthy individuals and patients with lupus are poorly understood. Our objectives were to identify novel alternatively spliced forms of PTPN22 and to examine the expression of PTPN22 isoforms in healthy donors and patients with lupus.

Methods

Various human PTPN22 isoforms were identified from the GenBank database or amplified directly from human T cells. The expression of these isoforms in primary T cells and macrophages was examined with real-time polymerase chain reaction. The function of the isoforms was determined with luciferase assays. Blood samples were collected from 49 subjects with SLE and 15 healthy controls. Correlation between the level of PTPN22 isoforms in peripheral blood and clinical features of SLE was examined with statistical analyses.

Results

Human PTPN22 was expressed in several isoforms, which differed in their level of expression and subcellular localization. All isoforms except one were functionally interchangeable in regulating NFAT activity. SLE patients expressed higher levels of PTPN22 than healthy individuals and the levels of PTPN22 were negatively correlated with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-DI).

Conclusions

The overall activity of PTPN22 is determined by the functional balance among all isoforms. The levels of PTPN22 isoforms in peripheral blood could represent a useful biomarker of SLE.     

系统性红斑狼疮患者外周血单个核细胞中C-myc和ras癌蛋白的表达及NK亚群的状况

作者检测了系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中 C-myc.Ki-ras 和Ha-ras 三种癌蛋白的表达和自然杀伤细胞(NK)亚群状况。结果显示,SLE 患者血液淋巴细胞和单核细胞中上述三种癌蛋白的阳性率均显著高亍健康对照组(P<0.001);而 SLE 组 NK 总数和CD16~+.CD16~+.57~+亚群细胞数则显著低于对照组(P<0.001)。作者结合文献讨论了 SLE 患者PBMC 中癌基因激活的可能机制和重要意义,以及与 NK 细胞和其亚群改变之间的相互关系。     

SLE带状疱疹患者外周血CD4~+CD28~+和CD4~+CD25~+FoxP3~+调节性T细胞的表达及相关性研究

目的:检测系统性红斑狼疮(systemic lupus erythematosus,SLE)合并带状疱疹患者外周血CD4~+CD28~+和CD4~+CD25~+Fox P3~+调节性T细胞的表达及相关性,探讨其在SLE合并带状疱疹发病中的临床意义。方法:采用流式细胞术检测30例SLE患者、30例SLE合并带状疱疹患者及30例健康对照者外周血中CD4~+/CD8~+T淋巴细胞亚群表面CD28的表达及CD4~+CD25~+Fox P3~+Treg细胞的表达水平,并分析SLE合并带状疱疹患者外周血CD4~+CD28~+和CD4~+CD25~+Fox P3~+调节性T细胞表达的相关性。结果:SLE合并带状疱疹组患者急性期外周血CD4~+T淋巴细胞比率、绝对计数显著降低,CD4~+、CD8~+T淋巴细胞表面的CD28表达下调,CD4~+CD25~+Fox P3~+Treg细胞水平显著高于SLE组及健康对照组,SLE合并带状疱疹组患者外周血CD4~+CD25~+Fox P3~+Treg水平与CD4~+CD28~+水平成负相关(P均0.05)。结论:SLE合并带状疱疹患者CD4~+、CD8~+T细胞活化异常,CD4~+CD25~+Fox P3~+Treg细胞可能参与抑制了T细胞的活化。     

The spliceosomal autoantigen heterogeneous nuclear ribonucleoprotein A2 (hnRNP-A2) is a major T cell autoantigen in patients with systemic lupus erythematosus

A hallmark of systemic lupus erythematosus (SLE) is the appearance of autoantibodies to nuclear antigens, including autoantibodies directed to the heterogeneous nuclear ribonucleoprotein A2 (hnRNP-A2), which occur in 20% to 30% of SLE patients as well as in animal models of this disease. To investigate the underlying cellular reactivity and to gain further insight into the nature and potential pathogenic role of this autoimmune response we characterized the T cell reactivity against hnRNP-A2 in patients with SLE in comparison to healthy controls. Cellular proliferation of peripheral blood T cells to hnRNP-A2 was determined by [3H]thymidine incorporation and T cell clones (TCCs) specific for hnRNP-A2 were grown by limiting dilution cloning; IFNγ, IL-4 and IL-10 in culture supernatants were measured by ELISA. Bioactivity of culture supernatants was determined by incubation of anti-CD3/anti-CD28 stimulated peripheral blood CD4+ T cells with supernatants of TCCs. Stimulation assays performed with peripheral blood mononuclear cells of 35 SLE patients and 21 healthy controls revealed pronounced proliferative responses in 66% of SLE patients and in 24% of the controls, which were significantly higher in SLE patients (p < 0.00002). Furthermore, hnRNP-A2 specific TCCs generated from SLE patients (n = 22) contained a relatively high proportion of CD8+ clones and mostly lacked CD28 expression, in contrast to TCCs derived from healthy controls (n = 12). All CD4+ TCCs of patients and all control TCCs secreted IFNγ and no IL-4. In contrast, CD8+ TCCs of patients secreted very little IFNγ, while production of IL-10 did not significantly differ from other T cell subsets. Interestingly, all CD8+ clones producing IL-10 in large excess over IFNγ lacked expression of CD28. Functional assays showed a stimulatory effect of the supernatants derived from these CD8+CD28- hnRNP-A2 specific TCCs that was similar to that of CD4+CD28+ clones. Taken together, the pronounced peripheral T cell reactivity to hnRNP-A2 observed in the majority of SLE patients and the distinct phenotype of patient-derived CD8+ TCCs suggest a role for these T cells in the pathogenesis of SLE.     

Expression of CD55 and CD59 on peripheral blood cells from systemic lupus erythematosus (SLE) patients

CD55 and CD59 are glycosylphosphatidylinositol-anchored proteins with complement inhibitory properties. CD55 inhibits the formation of C3 convertases, and CD59 prevents the terminal polymerisation of the membrane attack complex. It has been reported that SLE patients seems to have an acquired deficiency of these proteins associated with secondary autoimmune haemolytic anaemia and lymphopenia. The aim of this study was to evaluate the presence of altered CD55 and CD59 expression on peripheral blood cells from SLE patients. Flow cytometric analyses were performed on red and white blood cells from 23 SLE patients and 23 healthy controls. We observed more CD55- and CD59-lymphocytes (p = 0.005 and p = 0.019, respectively), and CD59-granulocytes (p = 0.045) in SLE patients than in controls. These results suggest there is an altered pattern of CD55 and CD59 expression on the peripheral blood cells of SLE patients, and it may play a role in the cytopenias in these patients.