摘要:
Objective To investigate the expression and role of regulatory plasma cells in gravidas with systemic lupus erythematosus ( SLE) . Methods Gravidas with SLE were enrolled in Henan Provincial People's Hospital from April 2013 to April 2018. They were divided into three groups including pregnancy control group, SLE stable group and SLE deterioration group. The ratio of CD3-LAG-3+CD138high regulatory plasma cells was detected by flow cytometry. The concentrations of soluble human leukocyte antigen-G ( sHLA-G) and anti-nuclear antibody Ig were detected by ELISA. Lymphocytes in peripheral blood of SLE deterioration group were isolated, and then cultured in RPMI1640 medium containing 10% fetal bovine ser-um and stimulated with HLA-G. Results Flow cytometry showed that the proportion of regulatory plasma cells in SLE stable group was (2. 483±0. 1318)% and that in SLE deteriorating group was (1. 662± 0. 1304)%. There was a significant difference between the two groups (t=4. 431, P=0. 0013). The con-centrations of sHLA-G in SLE stable group and SLE deteriorating group were (36. 50±3. 510) ng/ml and (16. 50±2. 405) ng/ml, and the difference between the two groups was statistically significant (t=4. 701, P=0. 0008). Correlation analysis showed that the concentration of sHLA-G was positively correlated with the proportion of regulatory plasma cells (r=0. 7471, P=0. 0009). The results of in vitro experiment showed that the proportions of B cells and regulatory plasma cells were ( 7. 573 ± 0. 6539 )% and ( 1. 593 ± 0.1879)% in SLE deterioration group and (3. 732±0. 7178)% and (2. 503±0. 2921)% in HLA-G group with statistical differences between the two groups (t=3. 957, P=0. 0027;t=2. 620, P=0. 0256). Conclusions The proportion of regulatory plasma cells and the concentration of sHLA-G were significantly decreased in pregnant patients with SLE, which was closely related to disease severity. HLA-G played an important role in promoting the proliferation of regulatory plasma cells.%目的 探讨调节性浆细胞在系统性红斑狼疮(systemic lupus erythematosus,SLE)合并妊娠患者中的表达及作用.方法 选取2013年4月至2018年4月来我院就诊的SLE合并妊娠的患者,分为对照妊娠组、SLE稳定组和SLE恶化组.流式细胞术检测CD3-LAG-3+CD138 high调节性浆细胞的比例;ELISA检测可溶性人白细胞抗原-G(sHLA-G)和抗核抗体Ig的浓度;分离SLE恶化组外周血中淋巴细胞,置于含有10%胎牛血清的RPMI 1640培养基中培养,并给予HLA-G蛋白刺激.结果流式细胞术结果显示SLE稳定组调节性浆细胞的比例为(2.483±0.1318)%,SLE恶化组的比例为(1.662±0.1304)%,两组间差异有统计学意义(t=4.431,P=0.0013);SLE稳定组的sHLA-G浓度为(36.50±3.510)ng/ml,SLE恶化组浓度为(16.50±2.405)ng/ml,两组间差异有统计学意义(t=4.701,P=0.0008);相关性分析的结果显示sHLA-G的浓度与调节性浆细胞的比例呈正相关(r=0.7471,P=0.0009);体外试验结果显示SLE恶化组B细胞和调节性浆细胞的比例分别为(7.573±0.6539)% 和(1.593±0.1879)%,HLA-G组的比例分别为(3.732±0.7178)% 和(2.503±0.2921)%,差异均有统计学意义(t=3.957,P=0.0027;t=2.620,P=0.0256).结论 SLE合并妊娠患者体内调节性浆细胞比例和sHLA-G浓度均显著降低,且与病情严重程度紧密相关,HLA-G具有促进调节性浆细胞比例升高的重要作用.