Graves病患者外周血中CD4+CD25+Treg细胞上的PD-1/PD-L1的表达及意义

目的:探究Graves病患者外周血中CD4+CD25+Treg细胞上的PD-1/P-L1的表达及意义。方法:收集2017年6月至2017年12月就诊于西南医科大学附属医院内分泌科的Graves病、Graves眼病及体检中心的健康者的外周血进行流式检测。结果:与正常对照组相比,Graves病及Graves眼病组CD4+CD25+Treg细胞比例明显降低(P0.05);PD-1+Treg、PD-L1+Treg、PD-1+/PD-L1+Treg细胞比例均较正常组明显降低(P0.05);此外,Graves眼病组的结果较Graves病组更低(P0.05)。结论:CD4+CD25+Treg的降低会导致Graves病和Graves眼病患者的免疫状态活化,甲状腺自身抗体的增加和活化,促进疾病的发生。此外于PD-1和PD-L1阳性细胞比例的减少对于其对免疫的负向调节有所减弱,从而导致患者体内免疫耐受的降低和免疫稳态的打破,可能导致机体对甲状腺抗原的耐受消失,导致GD及眼病的发生发展。

Expression and Significance of PD-1/PD-L1 on CD4+CD25+Treg Cells in Peripheral Blood of Patients with Graves Disease

ABSTRACT Objective: To explore the expression and significance of PD-1/PD-L1 on CD4⁺CD25⁺Treg cells in peripheral blood of patients of Graves Disease. Methods: This study recruited voluntary patients of Graves Disease and Graves ophthalmopathyand healthy volunteer from June 2017 to December 2017 in Southwest Medical Unniversity Affiliated hospital, and took samples of blood of them and use Flow cytometry to identify PD-1 and PD-L1 on CD4⁺CD25⁺Treg. Results: The frequency of CD4⁺CD25⁺Treg among PBMC in GD patient and GO patient decreased significantly(P<0.05), compared with normal control group. The PD-1 and PD-L1 expression on CD4⁺CD25⁺Treg in GD group and GO group was lower than that in normal control group(P<0.05) and them in GO group was lower than GD group(P<0.05). Conclusion: Decreased CD4⁺CD25⁺Treg will lead activation of immune responsem, to increase and activate thyroid autoantibodies and contributes to development of Graves disease and Graves Ophthalmopathy. Moreover, decreasd expression of PD-1 and PD-L1 can reduce their negative regulation,and lead to immune tolerance lowering and the disruption of immune homeostasis in vivo, and result in occurrence of Graves disease and Graves Ophthalmopathy.