调节性B细胞在类风湿关节炎发病中的作用和临床意义
发布时间：2019-05-19 21:30
【摘要】：目的:检测类风湿关节炎(RA)患者外周血CD19+CD24hiCD38hi、CD19+CD24hiCD27+调节性B细胞(Bregs)占CD19+B细胞的百分率,探讨外周血CD19+CD24hiCD38hiBregs、CD19+CD24hiCD27+Bregs频率与RA临床指标的相关性,明确治疗前后CD19+CD24hiCD38hiBregs的变化情况。方法:以CD19+CD24hiCD38hi作为Bregs标记,流式细胞仪三色荧光抗体标记法检测95例RA患者和40例健康对照者(HC)外周血CD24hiCD38hi细胞占CD19+B淋巴细胞的百分率,观察不同严重程度患者的CD19+CD24hiCD38hiBregs比例变化趋势,并研究其与RA患者疾病活动度指标(DAS28评分)、血沉(ESR)、超敏C反应蛋白(hc CRP)、类风湿因子(RF)、晨僵时间、视觉模拟评分(VAS评分)、关节肿胀数、关节压痛数以及其他相关性指标如年龄、病程、关节功能分级、日常生活能力(HAQ)评分等之间的相关性。随访其中25例RA患者,对比治疗6个月后较基线时外周血CD19+CD24hiCD38hiBregs的变化情况。另选57例RA患者和21例健康对照者,以CD19+CD24hiCD27+作为Bregs标记,通过流式细胞仪三色荧光抗体标记法检测外周血CD24hiCD27+细胞占CD19+B淋巴细胞的比例,结合临床资料进行相关性分析。结果:RA组CD24hiCD38hi细胞占CD19+B淋巴细胞的比例(6.48±4.98)%低于HC组(7.23±3.40)%,但两组间差异未达到统计学意义(p0.05)。其中DAS283.2组(n=19)、3.2≤DAS28≤5.1组(n=45)、DAS285.1组(n=31)CD24hiCD38hi细胞占CD19+B细胞的比例分别为(6.09±4.35)%、(6.15±5.28)%、(7.16±4.94)%,CD19+CD24hiCD38hiBregs的平均数量随疾病活动度的增高而增加。相关性分析发现RA患者CD19+CD24hiCD38hiBregs比例与晨僵时间呈正相关(r=0.227,p=0.027),与年龄、抗CCP抗体滴度水平均呈负相关(r=-0.234,p=0.022;r=-0.218,p=0.036)。外周血CD19+CD24hiCD38hiBregs的变化与治疗情况明显相关。病情无改善者(持续中重度活动,n=12)Bregs细胞数量增加,病情缓解者(由中重度活动到轻度活动或完全临床缓解,n=8)Bregs细胞数量下降,病情稳定者(持续处于轻度活动或病情完全缓解,n=5)Bregs细胞数量下降。RA组CD24hiCD27+细胞占CD19+B淋巴细胞的比例(12.36±7.08)%高于HC组(7.67±3.54)%,两组差异无统计学意义(p0.05)。RA组中DAS283.2组(n=25)和DAS28≥3.2组(n=32)间外周血CD24hiCD27+B细胞占CD19+B淋巴细胞的百分比分别为(9.07±6.27)%和(7.67±3.54)%,两组间差异无统计学意义(p0.05)。相关性分析发现RA患者CD19+CD24hiCD27+Bregs比例与年龄、病程、ESR、hs CRP、RF、抗CCP抗体、DAS28评分等均无相关性。结论:RA组外周血CD24hiCD38hiB细胞、CD24hiCD27+B细胞占CD19+B淋巴细胞的百分率与对照组间比例的差异情况未达到统计学差异,在RA患者中CD19+CD24hiCD38hiBregs随着病情活动性升高其数量反应性增加,随着治疗好转其数量随之降低,提示CD19+CD24hiCD38hiBregs在RA的发病及炎症活动中可能起一定作用。
[Abstract]:Objective: to detect the percentage of CD19 CD24hiCD38hi,CD19 CD24hiCD27 regulatory B cell (Bregs) in CD19 B cells in patients with rheumatoid arthritis (RA), and to explore the correlation between the frequency of CD19 CD24hiCD38hiBregs,CD19 CD24hiCD27 Bregs in peripheral blood and the clinical indexes of RA. The changes of CD19 CD24hiCD38hiBregs before and after treatment were determined. Methods: the percentage of (HC) peripheral blood CD24hiCD38hi cells in CD19 B lymphocytes in 95 patients with RA and 40 healthy controls was detected by flow cytometry with CD19 CD24hiCD38hi as Bregs marker. The change trend of CD19 CD24hiCD38hiBregs ratio in patients with different severity was observed, and the index of disease activity (DAS28 score) and erythrocyte sedimentation rate (ESR),) high sensitive C-reactive protein (hc CRP), rheumatoid factor (RF), morning stiffness time were studied. Visual simulation score (VAS score), number of joint swelling, number of joint tenderness and other related indexes such as age, course of disease, joint function grade, ability of daily living (HAQ) score and so on. Twenty-five patients with RA were followed up and the changes of CD19 CD24hiCD38hiBregs in peripheral blood after 6 months of treatment were compared with those at baseline. The proportion of peripheral blood CD24hiCD27 cells to CD19 B lymphocytes was detected by flow cytometry in 57 patients with RA and 21 healthy controls using CD19 CD24hiCD27 as Bregs marker. The correlation analysis was carried out with clinical data. Results: the proportion of CD24hiCD38hi cells in CD19 B lymphocytes in RA group (6.48 卤4.98)% was lower than that in HC group (7.23 卤3.40)%, but there was no significant difference between the two groups (p0.05). In DAS283.2 group (n 鈮，
本文编号：2481080
[Abstract]:Objective: to detect the percentage of CD19 CD24hiCD38hi,CD19 CD24hiCD27 regulatory B cell (Bregs) in CD19 B cells in patients with rheumatoid arthritis (RA), and to explore the correlation between the frequency of CD19 CD24hiCD38hiBregs,CD19 CD24hiCD27 Bregs in peripheral blood and the clinical indexes of RA. The changes of CD19 CD24hiCD38hiBregs before and after treatment were determined. Methods: the percentage of (HC) peripheral blood CD24hiCD38hi cells in CD19 B lymphocytes in 95 patients with RA and 40 healthy controls was detected by flow cytometry with CD19 CD24hiCD38hi as Bregs marker. The change trend of CD19 CD24hiCD38hiBregs ratio in patients with different severity was observed, and the index of disease activity (DAS28 score) and erythrocyte sedimentation rate (ESR),) high sensitive C-reactive protein (hc CRP), rheumatoid factor (RF), morning stiffness time were studied. Visual simulation score (VAS score), number of joint swelling, number of joint tenderness and other related indexes such as age, course of disease, joint function grade, ability of daily living (HAQ) score and so on. Twenty-five patients with RA were followed up and the changes of CD19 CD24hiCD38hiBregs in peripheral blood after 6 months of treatment were compared with those at baseline. The proportion of peripheral blood CD24hiCD27 cells to CD19 B lymphocytes was detected by flow cytometry in 57 patients with RA and 21 healthy controls using CD19 CD24hiCD27 as Bregs marker. The correlation analysis was carried out with clinical data. Results: the proportion of CD24hiCD38hi cells in CD19 B lymphocytes in RA group (6.48 卤4.98)% was lower than that in HC group (7.23 卤3.40)%, but there was no significant difference between the two groups (p0.05). In DAS283.2 group (n 鈮，
本文编号：2481080
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