导常型天疱疮自身抗原Dsg3片段的重组表达和特异性细胞反应

目的：探讨寻常型天疱疮自身抗原Dsg3在特异性T细胞反应中的作用，为自身免疫性疾病机制的研究提供依据。方法：根据Genbank中的Dsg3序列分析，采用RT-PCR法克隆自身抗原Dsg3E1,E2,E3,E4,E5多肽片段的cDNA,定向插入表达载体PGEX-2T，导入大肠杆菌JM109中表达重组融合蛋白并经GST层析柱纯化；进一步与PV患者及疾病对照组、正常对照组T细胞混合培养，观察T细胞增殖反应。结果：DsgE1，E2和E4，E5可刺激PV患者T细胞反应，而不与疾病对照组、正常对照组反应。结论：Dsg3E1,E2和E4，E5中包含T-B细胞作用相关的抗原表位，在PV发病中起重要作用。     

寻常型天疱疮的Dsg3特异性抗体反应及其基因限制性

探讨寻常型天疱疮中的自身抗原桥粒芯蛋白（Dsg3)特异性抗体反应及其基因限制性，为自身免疫性疾病机制的研究提供依据。采用RT－PCR法克隆自身抗原Dsg3E1,E2,E3,E4,E5多肽片段的cDNA，定向插入表达载体PGEX－2T，导入大肠杆菌JM109中表达重组融合蛋白并经GST层析柱纯化，进一步经免疫印迹法与PV患者阳性血清反应；应用序列特异性引物聚合酶链式反应（SSP－PCR）技术对HLA－Ⅱ类等位基因进行特异性体外扩增，分析了天疱疮患者HLA基因的DR位点的DRB1、DQB1多态性。Dsg3 E1,E2和E4可与PV患者阳性血清反应，而不与疾病对照组、正常对照组反应。在10个PV患者中，均携带HLA的DR4或／和DR14抗原，有7个DRB1*0402,4个DRB1*1401,7个DQB1*0302,4个DQB1*0503.Dsg3 E1,E2和E4中包含抗体反应相关的抗原表位，HLA DRB1*0402t DQB1＊0302与PV发病中抗E4抗体反应密切相关。     

Dsg3刺激诱导天疱疮患者一级亲属T细胞活化的研究

目的 研究在特异抗原桥粒芯糖蛋白3(desmoglein3,Dsg3)刺激下寻常型天疱疮(PV)患者一级亲属淋巴细胞Th1/Th2、Tc1/Tc2极化状态的变化,探讨PV发生机制.方法 PV患者一级亲属外周血单个核细胞(PBMC)在Dsg3刺激下体外培养3 d,流式细胞仪四色胞内染色分析PV患者一级亲属CD4~+ T细胞和CD8~+T细胞中IFN-γ~+和IL-4~+细胞的百分率,观察PV患者一级亲属Th1/Th2、Tc1/Tc2比例的变化.结果 PV抗体阳性一级亲属中的PBMC经Dsg3刺激培养者与未经Dsg3刺激者比较,Th2、Tc2百分率均显著升高(10.13%±3.72%vs 7.28%±3.58%,20.01%±10.43% vs 14.91%±8.06%,P<0.05);经Dsg3刺激培养后PV抗体阳性一级亲属组与正常对照组比较Th2、Tc2百分率均显著升高(10.13%±3.72%VS 6.10%±2.82%,20.01%±10.43% vs9.58%±5.49%,P<0.05).结论 特异性抗原Dsg3刺激下,自身反应性T细胞活化,Th1/Th2、Tc1/Tc2细胞分化失衡,可能在PV的启动阶段发挥重要作用.     

尖锐湿疣患者外周血T淋巴细胞上活化抗原的表达

目的 :探讨尖锐湿疣 (CA)患者外周血CD6 9和HLA DR分子在T淋巴细胞上表达的变化及其意义。方法 :采用免疫荧光三标记流式细胞术检测 30例CA患者外周血T细胞CD6 9和HLA DR抗原的表达 ,并以 31例正常人作为对照。结果 :CA患者外周血CD3 T细胞CD6 9的表达 (6 6 3%± 3 13% )与正常人对照组 (5 12 %± 1 6 4 % )相比 ,差异有显著性 (P <0 0 5 ) ,CD4 T细胞CD6 9的表达与正常人对照组相比 ,差异无显著性 (P >0 0 5 ) ,CD8 T细胞表达CD6 9水平 (4 6 1%± 3 0 9% )明显高于对照组 (2 6 7%± 1 31% ,P <0 0 1) ;患者组CD3 T细胞中HLA DR 细胞 (2 1 6 5 %± 8 84 % )比对照组 (13 5 6 %± 5 15 % )显著增高 (P <0 0 0 1)。结论 :CA患者外周血T淋巴细胞的激活以CD8 T细胞为主 ,其免疫激活状态在抗病毒感染中起着重要作用。     

寻常型银屑病皮肤真表皮T细胞分类比较

目的：探讨寻常型银屑病（PV）的免疫发病机制。方法：应用链霉卵白素－过氧化物酶法（SP法），比较不同病期寻常银屑病皮肤真皮T细胞表型表达及真皮微血管E－选择素表达变化等情况。结果：（1）PV进展期皮损表皮CD4^ 细胞、CD8^ 细胞及CD45RO^ 细胞，真皮CD3^ 细胞、CD4^ 细胞、CD45RO^ 细胞及CLA^ 细胞高于静止期（P均＜0．05）；（2）静止期皮损表皮CD3^ 细胞，真皮CD3^ 细胞、CD4^ 细胞、CD8^ 细胞、CD45RO^ 细胞及CLA^ 细胞高于消退期皮损，消退期皮损表皮CD8^ 细胞高于静止期（P均＜0．05）；（3）进展期皮损周边无损害皮肤真皮CD4^ 细胞高于静止期皮周（P＜0．05）；（4）PV正常皮肤与正常皮肤与正常人皮肤的T细胞各严型间差异无显著性（P＞0．05）；（5）E－选择素表达强度与PV皮损及皮损周边无损害皮肤中浸润的CLA^ 细胞数量间的关联具有显著性（P均＜0．05）。结论：PV皮损中浸润的T细胞主要表达CLA、CD45RO，CD4^ 细胞可能在PV的发生及维持中起一定作用，但不能排除CD8^ 细胞的作用，E－选择素与CLA间的相互作用在介导T细胞的皮肤归巢中发挥重要作用。     

肾移植排斥反应中细胞毒性T淋巴细胞相关抗原4的作用

背景：细胞毒性T淋巴细胞相关抗原4是新近发现的共刺激分子,在肿瘤及自身免疫性疾病中研究较多,在肾移植领域缺少研究。目的：探讨细胞毒性T淋巴细胞相关抗原4在肾移植排斥反应中的作用。方法：纳入肾移植患者50例,根据移植后肾功能分为2组,急性排斥组20例,移植肾功能稳定组30例。同时选择30例健康查体者作为健康对照组。分别抽取外周静脉血,采用ELISA法及流式细胞术检测观察对象血清及外周血淋巴细胞中的细胞毒性T淋巴细胞相关抗原4水平。结果与结论：细胞毒性T淋巴细胞相关抗原4在肾移植后急性排斥组、肾功能稳定组及健康对照组血清中的表达水平差异有显著性意义(F=70.008 1,P=0.000 0)。肾功能稳定组显著低于健康对照组(P=0.000 0),急性排斥组显著低于健康对照组(P=0.000 0),急性排斥组显著低于肾功能稳定组(P=0.000 0)。细胞毒性T淋巴细胞相关抗原4在肾移植后急性排斥组、肾功能稳定组及健康对照组淋巴细胞中的表达水平差异无显著性意义(F=1.865 6,P=0.161 7)。提示细胞毒性T淋巴细胞相关抗原4在肾移植患者发生排斥反应时血清中表达减低,具有一定的相关性,可能参与了排斥反应的发生。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：     

慢性肾炎患者外周血T细胞亚群和共刺激分子的表达及其意义

为研究慢性肾炎患者外周血T细胞亚群和共刺激分子的表达特点及其在慢性肾炎免疫病理机制中的作用 ,本文采用免疫荧光标记和流式细胞仪分析 ,对 35例慢性肾炎患者外周血T淋巴细胞亚群和共刺激分子CD2 8、 4 1BB等的表达进行研究。结果表明 :(1)慢性肾炎患者T细胞亚群明显失衡 ,表现为CD4减少 ,CD8增加 ,CD4/CD8比值显著降低 ;(2 )共刺激分子CD2 8表达显著低于正常对照组 (CD2 8表达百分率分别为 45 95± 5 6 7和 6 6 42± 4 5 8,P <0 0 0 1) ,且CD4+ CD2 8+ T细胞和CD8+ CD2 8+ T细胞均显著减少。治疗后缓解期患者T细胞亚群失衡明显纠正 ,CD2 8+ T细胞 ,尤其是CD4+ CD2 8+ T细胞显著增多 ,而且CD4+ CD2 8+ T细胞数与患者的 2 4h尿蛋白定量呈负相关 (r= 0 47,P <0 0 1) ;(3)慢性肾炎患者共刺激分子 4 1BB在T细胞中的表达显著高于正常对照组 (表达百分率分别为 30 5 7± 8 12和 0 74± 0 2 8,P <0 0 0 1) ,治疗后的 4 1BB表达水平显著降低 ,而且 4 1BB异常高表达与CD8+ T细胞数呈正相关 (r=0 6 3,P <0 0 5 )。从而表明慢性肾炎外周血T细胞亚群失衡和T细胞活化所必需的共刺激分子CD2 8、 4 1BB异常表达 ,可能在慢性肾炎发生和病变进展中起着重要作用。     

系统性红斑狼疮外周血单个核细胞CD28/B7分子mRNA的表达

目的 :探讨CD2 8 B7分子在系统性红斑狼疮 (SLE)发病机制中的作用及其临床意义。方法 :应用逆转录 聚合酶链反应 (RT PCR)检测 35例活动期SLE患者和 30例正常人外周血单个核细胞 (PBMC)中CD2 8、B7 1和B7 2mRNA的表达水平。结果 :35例活动期SLE患者PBMC中CD2 8的阳性表达率 (2 2 86 % )明显低于正常人对照组 (70 0 0 % ) ,差异非常显著 (P <0 0 0 1) ;B7 2的阳性表达率 (82 86 % )明显高于正常对照组 (5 3 33% ) ,差异显著 (P <0 0 1) ;活动期SLE组CD2 8的平均表达水平 (0 194 5± 0 2 0 74 )明显低于正常对照组 (0 4 2 38± 0 10 5 3) ,差异显著 (P <0 0 5 ) ;B7 2的平均表达水平 (0 86 75± 0 2 5 75 )明显高于正常人对照组 (0 4 898± 0 30 72 ) ,差异非常显著 (P <0 0 1) ;35例活动期SLE患者中仅有 2例B7 1呈阳性表达。结论 :CD2 8 B7分子的异常表达可能与SLE患者淋巴细胞和抗原呈递细胞 (APC)的功能变化有关。B7 1低水平与B7 2的高水平表达表明 ,SLE患者T细胞的活化可能主要是通过CD2 8与B7 2的交联传递共刺激信号 ,介导以Th2型反应为主的免疫应答反应 ;B7 2的表达水平可能与SLE疾病的活动性有一定的相关性。CD2 8mRNA的低水平表达可能与外周血CD2 8 T细胞凋亡增加或迁移到炎症部     

系统性红斑狼疮患者外周血淋巴细胞CD1c的表达

目的 :研究系统性红斑狼疮 (SLE)患者外周血淋血细胞CD1c的表达情况及与疾病活动性之间的关系。方法 :用流式细胞仪检测了 4 7例SLE患者外周血淋巴细胞CD1c的表达及淋巴细胞表型分析 ,并评价与疾病活动性的关系。结果 :SLE活动组病人CD1c 细胞百分率显著增高 (P <0 0 5 ) ,CD4 细胞百分率显著降低 (P <0 0 1) ,CD3 、CD8 细胞百分率正常 ,CD2 0 细胞数增高 (P <0 0 1)。稳定期病人CD1c 细胞百分率正常 ,CD4 、CD8 、CD2 0 细胞百分率均正常。SLE患者CD1c细胞阳性率与患者SLEDAI的评分有显著的相关性 (r=0 6 8,P <0 0 1) ,与抗dsDNA抗体的表达有显著相关性 (r =0 36 ,P <0 0 5 ) ,与抗心磷脂抗体的表达有显著的相关性 (r=0 6 4 ,P <0 0 1) ,与血清C3水平有显著相关性 (r =- 0 35 ,P <0 0 5 )。活动期病人经治疗后CD1c的表达明显下降。结论 :系统性红斑狼疮患者外周血CD1c表达与疾病的活动性明显相关 ,CD1c可能在SLE脂类抗原及核酸类抗原的递呈及抗双链DNA抗体、抗磷脂抗体的产生中起重要作用。     

T细胞免疫球蛋白粘蛋白分子-3与免疫调节的研究进展

T细胞免疫球蛋白粘蛋白分子3(Tim3)是一种Ⅰ型膜表面蛋白分子,属于新近发现的T细胞免疫球蛋白粘蛋白分子家族的一员。Tim3分子只选择性表达在分化的Th1细胞而不是Th2细胞上,可以作为新的区分Th1和Th2细胞的表面标志。Tim3分子通过与CD4 CD25 调节性T细胞和或抗原提呈细胞上表达的Tim3配体相互作用,抑制Th1免疫应答,在自身和异体免疫性疾病以及免疫耐受中起着重要作用。     

Detection of low avidity desmoglein 3-reactive T cells in pemphigus vulgaris using HLA-DR beta 1*0402 tetramers

In the present study, we developed a HLA class II tetramer-based detection system utilizing DRB1*0402 tetramers loaded with recently identified immunodominant peptides of desmoglein 3 (Dsg3), the major autoantigen of pemphigus vulgaris (PV). Initial experiments demonstrated staining of a Dsg3-reactive T cell hybridoma which was derived from HLA-DR0402-transgenic mice with loaded PE-labeled DRbeta1*0402 tetramers. However, staining of autoreactive T cell clones (TCC) derived from PV patients resulted only in positive staining by addition of exogenous peptides to the staining reactions. There was a dose-dependent specific binding of TCC to the tetramers with the agonistic Dsg3 peptide which was not altered by exogenous unrelated Dsg3 peptide. Noteworthy, the TCC did not stain with HLA-DR4 tetramers complexed with unrelated Dsg3 peptides. The findings of this study suggest that HLA class II tetramers may provide a highly specific approach to monitor ex vivo the T cellular autoimmune response against Dsg3 in patients with PV.     

Desmoglein 3-specific T regulatory 1 cells consist of two subpopulations with differential expression of the transcription factor Foxp3

Pemphigus vulgaris (PV) is an autoimmune bullous skin disorder associated with autoantibodies against desmoglein (Dsg) 3. An imbalance of type 1 regulatory T (Tr1) cells and T helper type 2 (Th2) cells specific for Dsg3 may be critical for the loss of tolerance against Dsg3 in PV. Within the population of Dsg3-responsive, interleukin (IL)-10-secreting Tr1 cell clones, two major subpopulations were identified and sorted by fluorescence-activated cell sorting (FACS) based on their size and granularity. Upon in vitro culture, the larger subpopulation differentiated back into the two former subpopulations of the Tr1 cell clones, while the smaller subpopulation died within 2 weeks. The smaller subpopulation of the Tr1 cell clones was characterized by the expression of Foxp3, the secretion of IL-10, transforming growth factor (TGF)-beta and IL-5 upon stimulation with Dsg3, a proliferative response to IL-2 but not to Dsg3 or mitogenic stimuli, and an inhibitory effect on the proliferative response of Dsg3-responsive Th clones in a Dsg3-specific manner. In contrast, the larger subpopulation showed a Th-like phenotype, lacking Foxp3, cytotoxic T-lymphocyte antigen 4 (CTLA4) and glucocorticoid-induced tumour necrosis factor receptor (GITR) expression and IL-2 secretion, and did not mount a proliferative response to Dsg3 and mitogenic stimuli. The two Tr1 subpopulations showed expression of identical T-cell receptor (TCR) V beta chains which varied among the PV patients studied. Upon inhibition of Foxp3, the smaller Tr1 subpopulation developed a proliferate response to Dsg3 and mitogenic stimuli, no longer suppressed Dsg3-specific Th cells, lost expression of GITR and CTLA4 and secreted IL-2. Thus, our observations suggest a distinct relationship between Dsg3-specific Tr1 and Th-like cells which may be critical for the continuous generation and survival of Dsg3-specific Tr1 cells.     

Cognate Th2–B Cell Interaction is Essential for the Autoantibody Production in Pemphigus Vulgaris

Pemphigus vulgaris (PV) is a Th2-dominant autoimmune skin disease. We showed that indeed active PV patients had a biased Th2 response and specific IgG4 autoantibodies were dominant. To further investigate the role of antigen-specific Th2 cells in the regulation of pathogenic Dsg3-IgG antibody production, we used recombined Dsg3 protein to immunize wild-type C57BL/6 mice with aluminum hydroxide or complete Freund’s adjuvant as adjuvant. CD4⁺ T cells from Dsg3-immunized mice were adoptively transferred into TCR-β chain deficient mice. The transferred CD4⁺ T cells were readily seen in the peripheral blood and spleen, and interacted with B cells, resulting in B-cell activation. Furthermore, transferred CD4⁺ T cells from mice immunized with Dsg3 plus Alum with Th2 phenotype were able to render unprimed B cells to secrete Dsg3-specific IgG1 antibody in vivo. Taken together, these results provide the first demonstration of direct role of Dsg3-reactive CD4⁺ T (Th2) cells in the regulation of pathologic anti-Dsg3 antibody production.     

T-cellular autoimmunity against desmogleins in pemphigus,an autoantibody-mediated bullous disorder of the skin

Pemphigus encompasses a group of life-threatening blistering diseases of the skin in which loss of adhesion between keratinocytes is caused by autoantibodies (Ab) against desmogleins (Dsg) 1 and 3. There is major interest in characterizing autoreactive T cells that are presumably critical for the induction and regulation of Ab production. In a recent study, peripheral Dsg3-reactive T helper (Th) cells from patients with acute onset, chronic active and remittent pemphigus vulgaris (PV) were quantitated by MACS secretion assay. Dsg3-reactive Th2 cells were detected at similar frequencies in all the studied PV patients while the number of autoreactive Th1 cells exceeded those of the Th2 cells in chronic active PV. Noteworthy, healthy carriers of the PV-associated HLA class II alleles, DRbeta1*0402 and DQbeta1*0503, exhibited exclusively Th1 reactivity against Dsg3. The titers of Dsg3-reactive IgG were directly related to the ratio of autoreactive Th1/Th2 cells. Moreover, T cell recognition of Dsg3 was restricted by these HLA class II alleles. These findings strongly suggest that (1) Dsg3-reactive Th2 cells are restricted to PV, (2) distinct HLA class II alleles are critical for T cell recognition of Dsg3, and (3) Ab production is associated with both, Th1 and Th2 cells.     

Humoral and cellular autoimmunity in autoimmune bullous skin disorders

Autoimmune bullous skin diseases, such as pemphigus vulgaris (PV) and bullous pemphigoid (BP), are severe, frequently life-threatening skin disorders. Immunologically, they are characterized by the presence of serum autoantibodies (auto-Ab) targeting distinct adhesion molecules of the epidermis or dermoepidermal basement membrane zone. Antibody (Ab) binding interferes with the adhesive function of these molecules, leading to detachment and subsequently blister formation. PV is the classical example of an Ab-mediated autoimmune disease affecting epidermal adhesion. Auto-Ab against the desmosomal adhesion molecule, desmoglein 3 (Dsg3), are critical in the pathogenesis of this disease, since the transfer of serum IgG Ab reactive with Dsg3 into newborn mice induces a bullous skin disease resembling PV. Autoreactive T cell responses to Dsg3 may be critical in the pathogenesis of PV because: (1) Ab production generally requires T cell help; (2) the involvement of CD4+ T lymphocytes in PV has been suggested by the strong association with distinct HLA class II alleles, and (3) T cell recognition of epitopes of Dsg3 may be crucial for the initiation and perpetuation of the production of Dsg3-specific auto-Ab by B cells. In PV and BP, autoreactive CD4+ T cells recognize distinct epitopes of the extracellular portions of Dsg3 and BP180 [BP antigen 2 (BPAG2) or type XVII collagen], respectively, and produce preferentially T helper type 2 (TH2) cytokines. Auto-Ab of the TH2-dependent IgG4 subtype are preferentially seen in the active stages of both PV and BP, while auto-Ab of the TH1-dependent IgG1 subclass are predominant during the chronic course of these disorders. These observations suggest that autoreactive TH2 cells may provide targets to specifically modulate the T cell-dependent production of pathogenic auto-Ab in these disorders.     

HLA class II restriction of autoreactive T cell responses in pemphigus vulgaris: review of the literature and potential applications for the development of a specific immunotherapy.

Pemphigus vulgaris (PV) is a life-threatening autoimmune bullous disease of the skin and mucous membranes which requires immunosuppressive therapy, most commonly a combination of glucocorticoids and additional immunosuppressive agents. Since the side effects of long-term immunosuppressive therapy contribute to the poor prognosis of this disorder, there is considerable interest in a more specific treatment of this severe skin disease. PV may serve as a model disease for the development of a specific immunotherapy, because its pathogenesis as well as involved immunogenetic factors are well-characterized. This review focuses on the characterization of autoreactive T cell responses to desmoglein 3 (Dsg3), the autoantigen of PV, that presumably regulate the production of autoantibodies by providing help to the autoreactive B cells. Current knowledge on T cell epitopes of Dsg3 and the HLA class II alleles that restrict Dsg3-specific autoreactive T cell responses, as well as potential applications for a specific immunotherapy of PV, are described.     

The molecular basis for the presence of two autoimmune diseases occurring simultaneously – Preliminary observations based on computer analysis

Specific Human Leukocyte Antigen Class II (HLA II) molecules associated with pemphigus vulgaris (PV), mucous membraine pemphigoid (MMP), and mixed connective tissue disease (MCTD) may react with multiple T cell epitopes within desmoglein 3 (Dsg 3), bullous pemphigoid antigen 2 (BPAG 2), and 70 kDa polypeptide small nuclear ribonucleoproteins (snRNP70) in autoantibody production. We report a group of patients with simultaneous occurrences of PV with MCTD, and MMP with MCTD. In one patient group, we performed serological studies to show presence of antibodies to Dsg 3, Dsg 1, and snRNP70 simultaneously. In the second group, we performed serological studies to show presence of antibodies to BPAG 1, BPAG 2, β4 integrin, and snRNP70 simultaneously. In both groups, HLA II genes were analyzed and the observations were consistent with previously described associations with PV, MMP, and MCTD. It is possible that HLA-DQβ1*0301 allele, present in 10 of 17 patients and DRβ1*04 in some of the others, may have the ability to bind to several relevant T cell epitopes in the snRNP70 molecule. We have utilized a computer model to demonstrate that HLA II-restricted T cell epitopes present within the known autoantigens may be capable of eliciting an immune response. While other explanations and mechanisms exist, the authors suggest that epitope spreading may be one possible mechanism, amongst others, that may result in the simultaneous presence of two separate pathogenic autoantibodies.     

Possible role of natural killer cells in pemphigus vulgaris - preliminary observations

Pemphigus vulgaris (PV) is an autoimmune blistering disease that affects the skin and multiple mucous membranes, and is caused by antibodies to desmoglein (Dsg) 1 and 3. Natural killer (NK) cells have a role in autoimmunity, but their role in PV is not known. NK cells in the peripheral blood leucocytes (PBL) of 15 untreated Caucasian patients with active PV were studied and compared with healthy controls for the expression of major histocompatibility complex (MHC) class II and co-stimulatory molecules. CD56+ CD16- CD3- NK or CD56+ CD16+ CD3- NK cells from the PBL of PV patients co-express MHC class II and co-stimulatory molecule B7-H3 without exogenous stimulation. CD4+ T cells from the PBL and perilesional skin of PV patients were co-cultured with CD56+ CD3- NK cells from the PBL of the same patients; in the presence of Dsg3 peptides underwent statistically significant proliferation, indicating that NK cells functioned as antigen-presenting cells. Supernatants from these co-cultures and serum of the same patients with active PV had statistically significantly elevated levels of interleukin (IL)-6, IL-8 and interferon-gamma, compared with controls indicating that the NK cells stimulated CD4+ T cells to produce proinflammatory cytokines. In these experiments, we present preliminary evidence that NK cells may play a role in the pathobiology of PV.