31例多发性硬化患者T淋巴细胞亚群及相关细胞因子 的检测

目的:探讨多发性硬化（MS）患者静脉血T淋巴细胞亚群及相关细胞因子的意义。方法:采用流式细胞术（FCM）检测31例MS患者治疗前（MS组）、泼尼松治疗4周后（泼尼松组）及20例健康者（正常组）外周血Th1（CD4+IFN-γ+）、Th2（CD4+IL-4+）、Th17（CD4+IL-17+）、Treg（CD4+FoxP3+）、Tc1（CD4-CD8+IFN-γ+）和Tc2（CD4-CD8+IL-4+）T淋巴细胞亚群变化；流式微球芯片捕获技术（CBA）检测血浆细胞因子IFN-γ、TNF-α、IL-17A、IL-4和IL-10的含量。结果:（1）FCM分析结果显示，与正常组比较，MS组Th1细胞和Th17细胞均明显升高（P＜0.05）；Treg细胞和Tc1细胞显著下降（P＜0.01），Th17/Treg比例明显升高（P＜0.01）；与MS组比较，泼尼松组Tc1、Tc2和Treg细胞百分率均明显升高（P＜0.01），而Th1和Th17细胞显著下降（P＜0.05），Th17/Treg比值降低（P＜0.01）；（2）CBA法检测结果显示，与正常组比较，MS组IFN-γ和IL-17A含量升高（P＜0.05；P＜0.01），IL-4和IL-10含量明显降低（P＜0.01）；与MS组比较，泼尼松组IL-17A含量明显降低（P＜0.01），IL-4和IL-10均显著升高（P＜0.01）。结论:MS的发生可能主要与Th17上调和Treg下调有关，提示临床上针对MS靶向下调Th17和上调Treg，纠正Th17/ Treg比例失衡，具有潜在应用价值。

Detection of Tlymphocyte subsets and related cytokines in 31 cases of multiple sclerosis

Objective: To investigate the levels of T lymphocyte subsets and related cytokines in 31 cases of the patients with multiple sclerosis(MS)and their significance to clinic. Methods: The lymphocyte subsets including Th1(CD4+IFN-γ+)，Th17(CD4+IL-17+)，Treg(CD4+FoxP3+)，Tc1（CD4-CD8+IFN-γ+） and Tc2（CD4-CD8+IL-4+）in peripheral blood mononuclear cells were determined by flow cytometry in three different groups;concentrations of plasma cytokines including IFN-γ，TNF-α，、IL-17A，IL-4 and IL-10 were determined by cytometric bead array. Results: Compared with normal control group,the percentages of Th1 and Th17 cells wereincreased significantly（P＜0.05）,while Treg and Tc1 cells were decreased significantly（P＜0.01），the proportion of Th17/Treg was increased significantly in MS group (P＜0.01）； compared with MS group, the percentages of Tc1，Tc2 andTreg cells were increased significantly（P＜0.05）,while Th17 and Th1 cells were reduced significantly（P＜0.01）,and the proportion of Th17/Treg was reduced significantly (P＜0.01） in Prednisone group; Compared with normal control group ,the concentration of IFN-γ and IL-17A were increased significantly（P＜0.05；P＜0.01）, while the concentration of IL-4 and IL-10 were decreased significantly in MS group（P＜0.01）; compared with MS group, the concentration of IL-17 A were decreased obviously（P＜0.05；P＜0.01）, while the concentration of IL-4 and IL-10 were increased significantly in prednisone group（P＜0.01）.Conclusion: The mechanism of multiple sclerosis might relate to Treg down -regulation,and Th17 cells up-regulation. Experiments in this paper show that it has potential application value forTreg up-regulation,and Th17 cells down-regulation，which could be used asan immunomdulatory therapy in the patients with clinical multiple sclerosis.