M受体拮抗剂对提高慢性阻塞性肺疾病患者调节性T细胞表达的影响

目的 观察COPD稳定期患者体内是否存在CD_8~+CD_(25)~+Foxp_3~+调节性T细胞(Treg细胞),以及M受体拈抗剂噻托溴铵对其表达的影响.方法 2007年10月至2008年3月,选择23例COPD稳定期患者,每日1次吸入噻托溴铵18 μg,连续治疗3个月.分别在治疗前后榆查患者的肺功能和检测外周血中T细胞亚群的数量.两组间均数比较采用配对t检验,相关分析采用直线相关分析.结果 COPD稳定期患者在吸入噻托溴铵治疗后,外周血巾CD_4~+为(36±46)%,CD_8~+CD_(25)~+Treg 细胞为(21±21)%,明显高于治疗前的(28±10)%和(8±8)%;CD_4~+CD_(25)~+为(4±3)%,明显低于治疗前的(10±7)%,差异均有统计学意义(t值为2.72～3.78,P<0.01和P<0.05).CD_8~+、CD_8~+CD_(25)~+和CD_4~+CD_(25)~+Treg细胞均有表达,但治疗前后无明显变化.治疗后肺通气功能得到明显改善,FEV_1、FEV_1占预计值%和FEV_1/FVC分别由(1.0±0.3)L、(35±10)%和(41±8)%提高到(1.1±0.3)L、(40±11)%和(45±11)%,差异均有统计学意义(t值为2.37～2.65,均P

Muscarinic cholinergic receptor antagonists enhanced the expression of CD_8~+CD_(25)~+Foxp_3~+ regulary T cells in stable COPD patients

Objective To investigate the levels of peripheral CD_8~+CD_(25)~+Foxp_3~+ regnlary T cells (CD_8~+CD_(25)~+ Treg)in stable chronic obstructive pulmonary disease(COPD)patients,and the effect of muscarinic cholinergic receptor antagonist,tiotropium bromide,on the expression of CD_8~+ CD_(25)~+ Treg.Methods From Oct.2007 to Mar.2008,23 patients with stable moderate to severe COPD received tiotropium bromide inhalation(1 8 μg daily)for 3 months.Before and after the use of tiotropium bromide,lung function was performed and peripheral vein blood samples were collected from the patient.Lymphocytes were isolated by three-color labeled monoelonal antibodies flow cytometry to detect the quantity and percentage of CD_8~+ T cell,CD_8~+ CD_(25)~+ T cell,CD_8~+ CD_(25)~+ Treg,CD_4~+ T cell,CD_4~+ CD_(25)~+ T cell and CD_4~+ CD_(25)~+ Treg,respectively.Paired t test was used for comparison between data before and after treatment.Results In patients with stable COPD.after tiotropium bromide treatment,the percentage of CD_4~+ T cells was increased from(28±10)% to (36±6)%,and the difference was significant(t=3.20,P<0.01).CD_4~+CD_(25)~+ was decreased from(10±7)%to(4±3)%(t=3.78,P<0.01),and CD_8~+ CO_(25)~+ Treg was incteased from(8±8)%to(21±21)%(t=2.72,P<0.05).At baseline,CD_8~+ cells,CD_8~+ CD_(25)~+ cells and CD_~+ CD_(25)~+ Treg were detectable in the peripheral blood,but no significant changes were observed after trealmenL After ireatment with tiotropium bromide,the lung function was markedly improved;FEV_1,FEV_1/Pre%.and FEV_1/FVC were increased from(1.0±0.3)L,(35±10)%and (41±8)%to(1.1±0.3)L.(40±11)%and(45±11)%,respectively(t=2.65,2.56 and 2.37,respectively,all P<0.05).By linear correlation analysis,the quantity of changes of CD_4~+ T cels and CD_4~+ cD_(25)~+ T cells were negatively correlated with the rate of change in CD_8~+ CD_(25)~+ Treg(r=-0.61,P<0.05 and r=-0.72,P<0.01,respectively).Conclusions In the peripheral blood of patients with stable COPD.there was expression of CD_8~+ CD_(25)~+ Treg and CD_4~+ CD_(25)~+ Treg The muscarinic receptor antagonist tiotropium bromide,promoted the amplification of CD_4~+,inhibited the expression of CD_(25)~+,and enhanced the expression of CD_8~+ Treg,suggesting that muscarinic receptor antagonist tiotropium bromide may possess immunomodulation function.