Ⅲ型前列腺炎患者外周血中CD4+CD25+Treg及前列腺液中MCP-1的检测及意义

摘要

目的 探讨Ⅲ型前列腺炎/慢性骨盆底疼痛综合征(CAP/CPPS)患者外周血中CD4+CD25+调节性T细胞占CD4+T细胞的比率以及检测其前列腺液(EPS)中单核细胞趋化蛋白-1(MCP-1)的水平,分析各检测指标与临床症状的相关性.方法 采用流式细胞仪检测48例CAP/CPPS患者和10例正常对照者外周血CD4+CD25+Treg占CD4+T淋巴细胞的百分比;ELISA法检测两组受试者EPS中MOP-1水平.结果 CAP/CPPS组外周血中CD4+T细胞及CD4+CD25highTreg/CD4+T细胞(28.12±4.32)%,(3.99±0.61)%与对照组(28.29±4.30)%(3.96±0.66)%相比;差异无统计学意义,P>0.05.Ⅲ a组外周血中CD4+T细胞及CD4+CD25highTreg/CD4+T细胞(28.33±4.35)%,(3.98±0.60)%与Ⅲb组(27.91±4.26)%(4.01±0.62)%相比;P>0.05.Ⅲ型组CD4+CD25+Treg/CD4+T细胞(6.48±1.34)%,低于对照组(14.66±2.16)%;P<0.01.CAP/CPPS组外周血中CD4+T细胞以及CD4+CD25hignTreg/CD4+T细胞与患者慢性前列腺炎症状指数评分(CPSI)均无相关性(P>0.05):CD4+CD25+Treg/CD4+T细胞与患者疼痛评分呈负相关(r=-0.702,P<0.05).CAP/CPPS组外周血中CD4+CD25+Treg/CD4+T细胞与EPS中MCP-1水平呈负相关(r=-0.682,p>0.05).CAP/CPPS患者前列腺液中MCP-1(0.45±0.09)ng/ml较对照组(0.18±0.02)ng/ml显著升高;P<0.01.Ⅲ a组EPS中MCP-1水平(0.54±0.02)ng/ml较Ⅲb组(0.35±0.02)ng/ml显著升高;P<0.01.CAP/CPPS组EPS中MCP-1水平与NIH-CPSI呈正相关(r=0.716,P<0.01),且与患者疼痛评分明显相关(r=0.875,P<0.01),CAP/CPPS患者前列腺液中MCP-1水平与EPS中白细胞数呈正相关(r=0.898,P<0.01).结论 Ⅲ型前列腺炎患者外周血中CD4+CD25+Treg数量表达下调,导致患者自身免疫反应增强,可能是CAP/CPPS的发病机制之一;MCP-1在CAP/CPPS的发病过程中起重要作用,并且与临床症状密切相关,MCP-1可能成为CAP/CPPS临床诊断的一个指标.%Objective To investigate the significant of CD4+CD25+Treg in peripheral blood and MCP-1 in rnexpressed prostatic secretion (EPS) in the pathogenesis of chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS). Metbods The ratio of peripheral blood CD4+C25+ regulatory T cells was detected by flow rncytometry from 48 CAP/CPPS patients and 10 normal controls. The level of MCP-1 in EPS was measured by ELISA.rnResults There was no significant difference between the(CAP/CPPS) patients and normal controls in the propotions rnof CD4+T cells and CD4+CD25h1gT regulatory cells in peripheral blood (P＞0.05); The propotion of CD4+CD25+T regulatory cells in peripheral blood were significantly lower than that of normal controls (P＜0.05), In addition, no rnsignificant correlation was found among the severity of symptoms (CPSI) and the propotions of CD4+T cells and rnCD4+CD25h1ghT regulatory cells in peripheral blood; The levels of MCP-1 in EPS of patients with CAP/CPPS were rnmarkedly increased compared with that of controls (P＜0.05). There was a positive correlation between the level of MCP- 1 rnand NIH-CPSI. The negative correlations between the CD4+CD25+T regulatory cells and MCP-1 were found. There was rnalso positive correlation between the MCP-1 and the pain index. In addition. The MCP-1 was positively correlated with rnWBC number in EPS. Conclusion The lower proportion of CD4+CD25+T regulatory cells in the patients with CAP/ rnCPPS which caused the increasing of autoimmunity, might be one of the mechanisms of CAP/CPPS. The MCP-1 might rnalso be associated with the pathogenesis of CAP/CPPS.