幼年特发性关节炎患儿外周血Th细胞亚群变化

目的探讨幼年特发性关节炎(JIA)患儿外周血CD4 T淋巴细胞及其亚群CD4 CD45RA 、CD4 CD45RO 的表达及其临床意义。方法采用免疫荧光标记技术和流式细胞仪检测36例JIA患儿外周血CD4 T淋巴细胞及其亚群CD4 CD45RA 、CD4 CD45RO 的表达,同期检测20例年龄、性别无差异的健康儿童为对照。结果JIA患儿外周血CD4 T淋巴细胞明显低于对照组(t=2.099,P<0.05),CD4 CD45RA T淋巴细胞数与对照组比较明显降低(t=3.450,P<0.01),CD4 CD45RO T淋巴细胞数明显升高(t=3.913,P<0.01),CD4 CD45RA T/CD4 CD45RO T比值明显降低(t=4.904,P<0.01);与对照组比较,JIA各亚型(全身型、多关节型、少关节型)的CD4 CD45RO T淋巴细胞数均明显升高,CD4 CD45RA T/CD4 CD45RO T比值明显降低(P<0.01);CD4 CD45RA T淋巴细胞数与正常对照组比较在全身型中显著降低(t=4.192,P<0.01);在多关节型中明显降低(t=2.214,P<0.05);在少关节型中稍有降低,但与对照组比较差异无显著性(t=1.793,P>0.05)。结论JIA患儿的免疫功能紊乱主要表现为CD4 T淋巴细胞及其亚群CD4 CD45RA T/CD4 CD45RO T失衡,这可能在JIA发病机制中起着重要的作用。

T-help lymphocyte and its subsets in peripheral blood of children with juvenile idiopathic arthritis

Objective To explore the expression of CD4 T(T-help lymphocyte) and its subsets CD4 CD45RA , CD4 CD45RO in peripheral blood (PB) of children with juvenile idiopathic arthritis (JIA). Methods The expression of CD4 T and CD4 CD45RA ,CD4 CD45RO in PB were measured using flow cytometry and monoclonal antibodies in 36 children with JIA. Twenty healthy children matched in age and gender served as normal controls. Results The CD4 T was significantly lower in children with JIA than that in normal controls(t = 2.099,P < 0.05). The percentage of CD4 CD45RO T (t = 3.913,P < 0.01) significantly increased whereas the percentage of CD4 CD45RA T (t = 3.450,P < 0.01) deceased in children with JIA,and there was an obvious decrease in the ratio of CD4 CD45RA T/CD4 CD45RO T in comparison with those in normal controls (P < 0.01). Furthermore,the increased percentage of CD4 CD45RO T and the decreased ratio of CD4 CD45RA T/CD4 CD45RO T were observed in all three types of JIA (systemic arthritis,polyarticular arthritis and oligoarthritis) in comparison with those in normal controls (P < 0.01 for all). The percentage of CD4 CD45RA T decreased significantly in children with either systemic arthritis or polyarticular arthritis in comparison with that in normal controls(t = 4.192,P < 0.01;t = 2.214,P < 0.05). There was no statistical difference between children with oligoarthritis and normal controls in the percentage of CD4 CD45RA T (t = 1.793,P > 0.05). Conclusions The disturbance of immune function appeared in children with JIA mainly presents as dysfunction of CD4 T and imbalance of CD4 CD45RA T and CD4 CD45RO T,which may play an important role in the pathogenesis of JIA probably.