天疱疮患者外周血滤泡辅助性T细胞的表达及其与血清抗Dsg抗体滴度的相关性

发布时间：2019-02-22 06:42

【摘要】：目的探讨天疱疮患者外周血滤泡辅助性T细胞(TFH)的表达及其与血清抗桥粒芯糖蛋白(Dsg)1,3抗体滴度的相关性。方法收集寻常型天疱疮患者59例,红斑型54例,其中初发患者36例,稳定期患者51例,复发患者26例;健康对照25例。采用流式细胞术检测不同病期患者外周血CD4+T细胞及CD4+CD45RA-活化T细胞中的TFH的比例(CXCR5+PD-1+),和健康对照进行比较;分析部分患者治疗前后TFH的变化情况;并进一步对活化TFH和特异性抗Dsg1,Dsg3抗体滴度的相关性进行研究。结果初发、稳定期和复发的天疱疮患者外周血滤泡辅助性T细胞占CD4+T细胞及活化T细胞的比例均显著高于健康对照组(P0.000 1)。治疗后患者的TFH明显下降,在活化T细胞中的比例下降更加明显。天疱疮患者外周血CD4+CD45RA-活化TFH与抗Dsg3抗体滴度呈微弱正相关(P=0.004)。结论天疱疮患者外周血TFH明显升高,与疾病的活动度有关,活化T细胞中TFH的比例变化更为敏感,可作为疾病活动度和疗效的评判指标。
[Abstract]:Objective to investigate the expression of (TFH) in peripheral blood follicular helper T cells in patients with pemphigus and its correlation with the titer of anti-desmosome glycoprotein (Dsg) 1 + 3 antibody. Methods 59 cases of pemphigus vulgaris and 54 cases of erythema were collected, including 36 cases of first onset, 51 cases of stable stage, 26 cases of recurrence, and 25 cases of healthy control. The percentage of TFH in CD4 T cells and CD4 CD45RA- activated T cells (CXCR5 PD-1) in peripheral blood of patients with different disease stages was detected by flow cytometry and compared with that of healthy controls, and the changes of TFH in some patients before and after treatment were analyzed. The correlation between activated TFH and specific anti-Dsg1,Dsg3 antibody titers was further studied. Results the percentage of peripheral blood follicular helper T cells in CD4 T cells and activated T cells in primary stable and recurrent pemphigus patients was significantly higher than that in healthy controls (P0.000 1). After treatment, TFH decreased significantly, and the proportion of activated T cells decreased more significantly. There was a weak positive correlation between CD4 CD45RA- activated TFH and anti Dsg3 antibody titer in pemphigus patients (P0. 004). Conclusion the level of TFH in peripheral blood of pemphigus patients is significantly increased, which is related to disease activity, and the ratio of TFH in activated T cells is more sensitive. It can be used as an index of disease activity and curative effect.
【作者单位】：上海交通大学医学院附属瑞金医院皮肤科;上海交通大学医学院上海市免疫学研究所;上海交通大学医学院附属瑞金医院北院皮肤科;
【基金】：国家自然科学基金面上项目(81171499;81472875);国家自然科学基金青年项目(81201230)
【分类号】：R758.66

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