初发SLE患者Th1/Th2及其调控因子基因的研究

目的：探讨未经药物治疗初发狼疮病人Th1/Th2细胞亚群分布及其调控细胞因子基因表达的差异。方法：运用三色荧光标记流式细胞术检测35例初发狼疮病人细胞亚群分布，并以10例正常人作对照；ABI 7700real-time PCR法同时检测38例病人和28例正常人IL－10、IL－12P40、IL18mPNA表达水平的差异。结果：1、初发狼疮病人Th1较正常人明显减低（P＜0．05），但Th1/Th2无显著性改变。2、与正常组相比，SLE组病人IL－12P35、IL－12P40、IL－18mRNA及其受体表达较正常人明显降低（P均＜0．05）；3、面部红斑组病人Th1/Th2、IL－12P35较正常组降低（P均＜0．05）；4、RNP阳性组病人IL－12P40较正常组升高，IL－12P35、IL－18较正常组降低（P均＜0．05）；5、有关节炎较无关节炎患者IL－18RmRNA表达升高（P＜0．05）。结论：SLE是一种以Th1细胞下降，Th2细胞相对占优势的自身免疫性疾病，源于诱导向Th1细胞分化的一系列细胞因子及其受体减少和细胞因子间失衡所致。

Study on Th1/Th2 Balance and Regulatory Cytokines in the Initial-Onset SLE Patients

Objective To analyze the Th1/Th2 balance of peripheral Th cells and its inducing cytokines in recent onset SLE patients and to elucidate the cause of immunological inbalance in SLE patients. Methods The intracellular cytokine detection method with flow cytometry was used to quantitate Th1/Th2 cells in initial SLE patients(n=35) and the controls (n=10).At the same time,ABI 7700 real time PCR was used to detect IL-10,IL-12 and IL-18 mRNA expression in SLE patients (n=38,35came from above)and the controls(n=28,10came from above). Results There was no difference in the Th1/Th2 ratio between SLE patients and the controls(P>0.05).However,Th1 was decreased significantly in the SLE group than that in the normal control group(P<0.05).The cytokines including IL-12P35,IL-12P40?IL-18 and IL-12P35/IL-10?IL-18/IL-10 were all significantly decreased in the SLE group than that in the control(P<0.05),IL-12P40 incresed in the RNP positive group however.There is no difference in IL-10 between SLE patients and normal controls (P>0.05), but IL-10R and IL-10 increased significantly in SLE patients with serum RNP posivtve. SLE patients with malar rash had a significantly lower Th1/Th2 ratio and IL-12P35 mRNA expression. SLE patients with RNP positive not only had higher IL-12 P40 expression but also significantlydecreased in IL-12P35.SLE patients with arthritis had higer IL-18R mRNA expression. Conclusion SLE is a relative Th2 predominant disease due to decrease in Th1 as well as decrease in IL-12,IL-18 mRNA expression.SLE patient with malar rash and the RNP positive may be the special subtype of SLE for they have different Th distribution and different imbalance cytokines expression.