胸腺成熟树突状细胞与重症肌无力发生的相关性分析

目的 探讨胸腺成熟树突状细胞(mDC)数量与分布的改变与重症肌无力(MG)发生的关系.方法 选取胸腺切除前未行免疫抑制治疗的MG患者39例为研究组,同期因心脏病手术需行胸腺部分切除的患者19例为对照组.性别和年龄在两组中的分布差异无统计学意义(P>0.05).以DC-LAMP作为胸腺mDC的标志物,用免疫酶组织化学方法显示mDC在胸腺的表达情况,图像分析软件辅助分析.结果 (1)对照组mDC严格地限定在胸腺體质区和皮髓交界区;MG组mDC分布不规则,在髓质、皮质和间质均能见到.(2)对照组mDC大致呈均匀分布在髓质区.MG组则较多地见到成簇分布,尤其在生发中心周围往往出现mDC密集包绕表现.(3)mDC阳性区平均视野细胞相对比例和绝对数MG组(10.9%±2.2%,50±9)均高于对照组(8.5%±1.5%,41±7)(P<0.05).结论 MG患者胸腺组织存在mDC数量的增多及分布的异常.这种异常提示mDC可能积极地参与了MG的发病过程.

Correlation between pathogenesis of myasthenia gravis and thymus mature dendritic cells

Objective To investigate the correlation between onset of myasthenia gravis (MG) and the changes of the number and distribution of thymus mature dendritic cells (mDC).Methods The specimens of thymus were obtained during operation from 39 MG patients who hadn' t received immunosuppressive therapy before thymectomy and 19 sex- and nge-matched patients who underwent cardiosurgery as controls.Immunohistochemistry with antibody against DC-LAMP, specific surface marker of DC, was used to examine the number and distribution of thymus mDCs.Results(1) mDCs were restricted in the medulla and cortex-medulla junctional zone of thymus in the control group; while were irregularly distributed in the cortex, medulla, and stroma in the MG group.(2) mDCs presented a roughly uniform distribution in the medulla of thymus in the control group, while clustering distribution was more often in the MG group, especially dense around the germinal center.(3) The relative ratio and numbers of mDCs per average field of vision in the positive areas of the MG group were(10.9% ± 2.2%) and(50 ± 9), beth significantly higher than those of the control group [ (8.5% ± 1.5%) and (41 ±7) respectively, both P < 0.05 ].Conclusion The number and ratio of the thymus mDCs in MG are high, high, and the distribution abnormal.mDC actively may be actively involved in the pathogenesis of MG.