沙利度胺联合甲氨蝶呤对类风湿性关节炎患者外周血调节性T细胞及细胞因子IL－6表达的调节作用

摘要

Objective To investigate the effect of before and after combination therapy of thalidomide and methotrexate (T+M) on regulatory T cells and IL-6 expression profile,and to reveal the mechanism of therapeutic effect of T+M on rheumatoid arthritis.Methods A total of 58 patients with rheumatoid arthritis from August 2014 to August 2016 in the Third Affiliated Hospital of Wenzhou Medical University.The flow cytometry assay and enzyme-linked immunosorbent assay (ELISA) were used to estimate the ratio of peripheral blood regulatory T cells and expression profile of IL-6 in peripheral blood lymphocyte before and after combination therapy of thalidomide and methotrexate .Results After combination therapy of T+M,the ratio of peripheral blood CD25 +Foxp3/CD4 +T cells had a marked increase compared with before combination of therapy of T +M;but the expression of IL-6 had a significant decrease in the group of after combination therapy of T +M compared with before combination therapy.Conclusion The effect of combination therapy of T+M on rheumatoid arthritis is associated with increasing the ratio of regulatory T cells and decreasing the secretion of IL-6 that could regulate T cells to homeostasis.%目的：分析沙利度胺联合甲氨蝶呤（thalidomide＋methotrexate， T＋M）治疗类风湿性关节炎（rheumatoid arthritis，RA）前后调节性T细胞比例及细胞因子白介素－6（interleukin－6，IL－6）表达情况，揭示T＋M治疗RA作用机制。方法选取2014年8月～2016年8月温州医科大学附属第三医院血液科就诊治疗的类风湿性关节炎58例患者，沙利度胺联合甲氨蝶呤治疗前后流式细胞术检测外周血调节性T细胞比例，对比分析T＋M治疗前后调节性T细胞比例变化；酶联免疫吸附测定（ enzyme linked immunosorbent assay，ELISA）检测外周血中淋巴细胞分泌细胞因子IL－6表达情况。结果 T＋M治疗后组RA患者外周血调节性T细胞（ CD25＋Foxp3／CD4＋）比例较治疗前组明显增加；然而，T＋M治疗后组IL－6表达水平同治疗前组相比明显下降。结论 T＋M治疗RA可能是通过增加调节性T细胞以及减少细胞因子IL－6而调控T细胞稳态而起作用。