视神经脊髓炎(谱病)患者外周血T细胞受体可变区β链多态性研究

摘要

目的 了解视神经脊髓炎(NMO)患者与视神经脊髓炎谱病(NMOSD)患者外周血T细胞受体可变区β链(TCRVβ)表现特点.方法 收集NMO患者7例,NMOSD患者23例,健康志愿者30例,采取EDTA抗凝外周血2mL,应用TCRVβ单克隆抗体标记后进行流式细胞仪分析,应用相关软件分析24个TCRVβ亚家族成员表达水平.结果 NNO、NMOSD组TCRVβ扩增率、扩增程度较对照组增高(P<0.05),组间比较差异无统计学意义(P>0.05);NMO组CD4+TCRVβ5.1、CD8+TCRVβ13.6,NMOSD组CD4+TCRVβ2、CD8+TCRVβ2扩增频率高于对照组(P<0.014),NMO组CD8+TCRVβ11,NMOSD组CD4+TCRVβ11、CD8+TCRVβ11表达水平低于对照组(P<0.05),NMO组CD8+TCRVβ13.6扩增频率高于NMOSD组(P<0.014),NMO组CD8+TCRVβ9、17表达水平低于NMOSD组(P<0.05).ROC曲线分析提示CD8+TCRVβ11的定量分析对NMO+NMOSD的诊断,CD4+TCRVβ2的定性分析、CD8+TCRVβ11的定量分析对NMOSD的诊断具有中等意义诊断价值.结论 可通过检测部分TCRVβ片段对NMO与NMOSD的诊断提供方法与初步依据.%Objective To investigate the usage of T cell receptor β chain variable region(TCRVβ) in peripheral blood of NMO and NMOSD patients.Method Hospitalized patients of Xuanwu Hospital, which were divided into 3 groups. Two experimental groups: NMO group of 7 patients, NMOSD group of 23 patients, and the control group: 30 healthy volunteers. To took 2mL EDTA anticoagulated peripheral blood from subjects, then to analysis the usage of TCRVβ by flow cytometry. We got the statistic of the qualitative and quantitative expression of the total 24 subfamilies of TCRVβ.Results The expansion of the TCRVβ in the disease groups were significantly higher than the control group(P<0.05), there were no significant different between disease groups(P>0.05). Compared to the control group, CD4+TCRVβ5.1 and CD8+TCRVβ13.6 were significantly expanded in NMO group, CD4+TCRVβ2 and CD8+TCRVβ2 were significantly expanded in NMOSD group, CD8+TCRVβ11 were significantly reduced in NMO group; CD4+TCRVβ11 and CD8+TCRVβ11 were significantly reduced in NMOSD group. The CD8+TCRVβ13.6 in NMO group were significantly expanded than NMOSD group, CD8+TCRVβ9, 17 in NMO group were significantly reduced than NMOSD group. Receiver operating characteristic(ROC) curve analysis indicated that CD8+TCRVβ11 has some diagnostic value for NMO and NMOSD, CD4+TCRVβ2 and CD8+TCRVβ11 have some diagnostic value for NMOSD. Conclusion The early diagnosis of NMO and NMOSD can be partly solved by detecting some TCRVβ fragments.