Graves病患者外周血CD4~＋CD28~-T细胞亚群检测的临床意义

目的分析Graves病（GD）患者外周血CD4＋CD28-T细胞亚群的数量和功能的变化,并初步探讨其在GD发病中的可能作用。方法采用荧光标记、胞内细胞因子染色和流式细胞术分析61例GD患者外周血CD4＋CD28-T细胞的表型特征,并与30名GD组相匹配的健康受试者作对照。结果与正常对照组相比,CD4＋CD28-T细胞在GD患者外周血中显著升高（P〈0.01）,并且呈现其百分率与该病的临床体征甲状腺肿大和突眼及甲状腺自身抗体TRAb成正相关;CD4＋CD28-T细胞表面上调表达共刺激分子ICOS,活化诱导后分泌IFN-γ,呈现出Th1样功能特征。结论循环CD4＋CD28-T细胞可能是参与GD自身免疫病理的自身免疫反应性T细胞。

The Role of Circulating CD4+ CD28- T Cell in the Development of Graves' Disease

Objective To examine the prevalence and clinical relevance of CD4 ＋CD28-T cells in a cohort of Graves＇ disease（GD） patients,to characterize functional properties of these abnormal T cells.Methods The size,phenotype and intracytoplasmic cytokine expression of the peripheral blood CD4 ＋CD28-compartment was determined in 61 cases of GD patients by immunophenotyping and flow cytometry analysis,and 30 age-matched healthy donors were taken as the controls.Results Circulating CD4 ＋CD28-T cells were found to be more enriched in patients with GD than in the controls.Levels of CD4 ＋CD28-T cells correlated with disease manifestation and thyroid autoantibody TRAb.Alternative costimulatory molecule ICOS were up-regulatedly expressed on the surface of CD4 ＋CD28-T cells.They produced IFN-γ and shared Th1-like functional properties.Conclusion Circulating CD4 ＋CD28-T cells may play an important role in pathogenesis and development of GD.