NMOSD患者外周血滤泡辅助性T细胞及其亚群的表达研究

摘要

目的 通过研究视神经脊髓炎谱系疾病(NMOSD)患者外周血中滤泡辅助性T(Tfh)细胞的表达,探讨Tfh细胞与NMOSD发病的关系.方法 采用流式细胞术分别检测53例NMOSD急性发作期患者(NMOSD组)和20名健康对照(对照组)的外周血中不同表型的Tfh细胞占CD4+T细胞的比例及其三个亚群Tfh1、Tfh2、Tfh17占CD4+CXCR5+T细胞的比例.结果 NMOSD组CD4+CXCR5+Tfh细胞 、CD4+CXCR5+PD-1+Tfh细胞占CD4+T细胞的比例均高于健康对照组〔分别(22.80±6.78)%vs.(18.94±3.84)%,t=3.042,P=0.003;(9.54±3.29)%vs.(4.21±1.31)%,t=9.914,P=0.000〕.在CD4+CXCR5+T细胞中,NMOSD患者组Tfh17细胞所占比例高于对照组〔(30.70±4.56)%vs.(27.33±2.89)%,t=3.071,P=0.003〕,Tfh1细胞比例低于对照组〔(26.41±4.42)%vs.(30.26±3.66)%,t=-3.474,P=0.001〕,Tfh2细胞比例与对照组差异无统计学意义(P=0.127);(Tfh2细胞比例+Tfh17细胞比例)/Tfh1细胞比例的比值高于对照组(2.41±0.65 vs.1.88±0.39,t=4.264,P=0.000).结论 NMOSD急性发作期患者外周血中Tfh细胞比例增高,同时存在着Tfh细胞的三个亚群的比例失调,尤其是Tfh17细胞比例显著增高,推测Tfh细胞与NMOSD的发病存在一定关系.%Objective The study was aimed at exploring the relationship between Tfh cells and the pathogenesis of neuromyelitis optica spectrum disorders (NMOSD ) by studying the expression of Tfh in the peripheral blood of NMOSD patients. Methods By the means of flow cytometry ,the percentages of different phenotypes of Tfh cells and three distinct Tfh cell subsets ( Tfh1 ,Tfh2 and Tfh17 ) in the peripheral blood of 53 NMOSD patients with acute episodes (NMOSD group) and 20 sex and age-matched healthy controls (control group) were examined. Results The percentages of CD4 + CXCR5 + Tfh cells and CD4 + CXCR5 + PD-1 + Tfh cells among CD4 + T cells was significantly increased in the peripheral blood of the NMOSD group compared with control group , [ (22.80 ± 6.78)% vs. (18.94 ± 3.84)% , P= 0.003 ; (9.54 ± 3.29)% vs. (4.21 ± 1.31)% , P = 0.000 ; respectively ] . Among CD4 + CXCR5 + T cells , the percentage of Tfh17 cell subset 〔 (30.70 ± 4.56)% 〕 in the NMOSD group was significantly higher than that in the control group [ (27.33 ± 2.89)% ] (P= 0.003) , while the percentage of Tfh1 cell subset [(26.41 ± 4.42)% ] in the NMOSD group was lower than that in the control group 〔 (30.26 ± 3.66)% 〕 (P= 0.001) . In addition , the percentage of Tfh2 cell subset in the NMOSD group showed no significant statistical difference by compared with the control group (P= 0.127) . Moreover ,the ratio of (% Tfh2 + % Tfh17) /% Tfh1 in the NMOSD group was found to be significantly higher that than in the control group (2.41 ± 0.65 vs .1.88 ± 0.39 , P= 0.000) . Conclusions In acute episodes ,the percentage of Tfh cells increased significantly in the peripheral blood of the NMOSD patients. At the same time , the balance of three Tfh cell subsets (Tfh1 ,Tfh2 and Tfh17) was altered in NMOSD patients ,especially the percentage of Tfh17 cell subset was significantly increased. These data indicats that certain relationship exists between Tfh cells and the pathogenesis of NMOSD.