抗中性粒细胞胞质抗体对中性粒细胞表面FcγⅡ/Ⅲ受体表达的影响及其意义

目的 探讨抗中性粒细胞胞质抗体(ANCA)对中性粒细胞表面FcγⅡ/Ⅲ(CD32/CD16)受体表达的影响及临床意义.方法 提纯活动期ANCA相关性小血管炎(AASV)患者的ANCA IgG,分离健康人新鲜中性粒细胞,以ANCA刺激粒细胞1 h后,流式细胞仪检测CD32/CD16的表达.流式细胞仪检测18例系统性小血管炎患者CD32/CD16的表达,以35名健康人为对照.同时对18例患者临床表现及血管炎活动情况进行评分,与CD32/CDl6表达进行相关分析.结果 ANCA IgG与正常人IgG相比显著上调中性粒细胞表面CD16的表达(Mnx 67±23 vs 54±21,P<0.01),但对CD32的表达无影响(Mnx 21±8vs 16±8,P>0.05).系统性小血管炎患者CD16表达的平均荧光强度显著高于正常人(Mnx 62±12 vs 53±10.P<0.01),而CD32的表达与正常人差异无统计学意义.CD16表达与伯明翰小血管炎呈显著正相关(P<0.01).结论 ANCA相关性小血管炎患者高表达Fcγ受体,ANCA可以干预CD32/CD16受体的表达,调控FCγ受体表达可能是系统性小血管炎的发病机制之一,监测CD16的表达水平对于判断疾病活动具参考价值.

The expression of neutrophils FCγRⅡ/Ⅲ modulated by anti-neutrophil cytoplasmic antibodies and its clinical value

Objective The interaction between anti-neutrophil cytoplasmic antibaties (ANCA) and receptors at the Fc portion of immunoglobulins (FeγR) is central in the pathogenisis of primary systemic small vasculitis. The aim of this study is to investigate the role and clinical value of ANCA on the expression of neutrophils FCγRⅡ/Ⅲ (CD32/CD16). Methods ANCA IgG was prepared from the sera of patients with active We-gener's granulomatosis (WG) and microscopic polyangiitis (MPA). Neutrophils were isolated from the blood of healthy volunteers. The expression of CD32/CD16 on neutrophils was assessed by flow cytometry after stimulated by ANCA for 1 hour. We compared the expression of CD32/CD16 between 18 primary systemic small vaseulitis (PSV) patients and 35 healthy volunteers. Furthermore, the correlation was also be analyzed between the expression of CD32/CD16 and Birmingham vasculitis activity score (BVAS). Results The expression of CD16 was significandy elevated by ANCA (Mnx 67±23 vs 54±21, P<0.01 ). The expression of CD16 was higher in patients than in healthy volunteers (Mnx 62±12 vs 53±10, P<0.01), which was in correlation with BVAS (r=0.728 86, P<0.01). But no such correlation was found for CD32 . Conclusion ANCA may play a role in the pathogenesis of PSV by modulating the expression of the FCγR. Monitoring the expression of CD16 on neutrophils is helpful for the evaluation of PSV activity. 86, P<0