特应性皮炎患者外周血滤泡性辅助性T细胞的特征

摘要

目的 探讨特应性皮炎(AD)患者外周血滤泡性辅助性 T(Tfh)细胞的表达特征,分析其在特应性皮炎发病机制中的作用.方法 选择该院20例AD患者(AD组),运用欧洲特应性皮炎评分系统(SCORAD)评估病情严重程度.采用中药汤剂口服和他克莫司软膏外用治疗,治疗时间1个月.使用流式细胞技术检测患者治疗前、治疗1个月后和12例健康对照者(健康对照组)外周血T fh细胞的频率及其表面程序性死亡受体1(PD-1)、诱导性共刺激分子(ICOS)的表达水平,并分析其与AD严重程度的相关性.结果 与健康对照组比较,AD组外周血Tfh细胞频率明显升高,差异有统计学意义(P<0.05).Tfh细胞PD-1、ICOS 表达水平在AD组患者显著升高,差异有统计学意义(P<0.05).Tfh细胞频率与AD严重程度呈正相关关系(P<0.05), Tfh细胞PD-1、ICOS表达水平仅SCORAD评分升高而升高,但差异无统计学意义(P>0.05).经1个月治疗,患者皮疹好转、瘙痒减轻,外周血 Tfh 细胞频率及其表面 PD-1、ICOS 表达水平较治疗前明显降低(P<0.05).结论 Tfh细胞频率和功能在AD患者外周血均发生改变,该细胞可能在AD的免疫学发病机制中具有重要的临床作用.%Objective To investigate the characteristics of follicular helper T(Tfh)cells in peripheral blood of patients with atopic dermatitis(AD),and to assess their roles in the immune pathogenesis of atopic dermatitis.Methods A total of 20 patients with atopic dermatitis and 12 health controls were enrolled in our study.The severity of atopic dermatitis was assessed by Scoring Atopic Dermatitis Index(SCORAD).All the patients were treated by Chinese traditional medicine and tacrolimus ointment.The Tfh cells frequency and ex-pressions of programmed death 1(PD-1),inducible costimulatory molecule(IOCS)on Tfh cells in peripheral blood of healthy normals,AD patients before and after 1-month treatment were measured by flow cytometry. The frequency of Tfh cells and expressions of PD-1,IOCS on Tfh cells between patients and health controls were analyzed,and the changes of those detective markers in AD patients before and after 1-month treatment were invested as well.Results Compared with health controls,the frequency of Tfh cells in AD patients was significantly increased(P<0.05).In addition,the expressions of PD-1 and IOCS on Tfh cells were significant-ly higher than them in health individuals as well(P<0.05).The frequency of Tfh cells in AD patients was positively correlated with SCORAD score(P<0.05),while the expressions of PD-1 and IOCS on Tfh cells did not correlated with SCORAD score.Furthermore,the Tfh cells frequency and the expressions of PD-1 and IOCS on Tfh cells were dramatically decreased after 1-month treatment(P<0.05).Conclusion The frequen-cy and function of Tfh cells were changed in AD patients,and Tfh cells may play important roles in the im-mune mechanism of atopic dermatitis.