系统性红斑狼疮患者淋巴细胞亚群早期凋亡的初步研究

目的：检测系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中不同细胞亚群发生凋亡的情况，并初步分析其在SLE发病机制中的意义。方法：取28例SLE患者和性别年龄与之相匹配的20个正常对照者。采用淋巴细胞亚群标志、Annexin-V及碘化丙啶三色荧光标记、流式细胞术检测细胞的早期凋亡。结果：SLE患者体内CD3^ T细胞、CD4^ T细胞和CD8^ T细胞的凋亡百分率均显著高于正常对照组(P＜0．05)。同时，SLE患者T淋巴细胞的死亡百分率也高于正常人。经激素治疗一定时间后，这些细胞亚群的凋亡率会进一步升高(P＜0．01)，但CD4／CD8比值恢复至接近正常人。SLE患考体内CDl9^ B淋巴细胞的凋亡或死亡百分率和正常对照组相比均无明显差别，激素治疗对B细胞凋亡和死亡的影响亦不显著。结论：在SLE患者体内主要是T淋巴细胞凋亡增加，但SLE患者淋巴细胞数目减少不仅仅是因为细胞凋亡所致，死亡细胞数目明显升高也是其中一个重要原因。激素治疗可诱导SLE患者T淋巴细胞进一步发生凋亡，并使T细胞亚群比例有所改善。

High Levels of Early Apoptic T Lymphocytes in Systemic Lupus Erythematosus

Objective: To investigate the abnormal apoptosis of the subpopulation of peripheral blood mononuclear cells(PBMC) from SLE patients and to evaluate the possible pathological contribution of PBMC apoptosis to SLE disease. Methods: Three-colour immunofluorescence and flow cytometry were employed to determine the percentages of early apoptic subsets by binding Annexin V-FTTC but not PI and of dead cells by binding both Annexin V-FITC and PI. Results: Compared with normal controls, there were significantly higher apoptic and dead cells in CD3+T cells,CD4+T cells and CD8+T cells but not in CD19+B cells from SLE patients. After glucocorticoid (GC) treatment, the percentages of apoptosis in CD3+T cells, CD4+T cells and CD8+T cells further increased significantly in SLE patients while the ratio of CD4/CD8 recovered approximately to normal level. Conclusion: The percentage of early apoptic T lymphocytes is significantly higher than normal controls and will be much more increased by GC treatment. It is possible that the increased apoptosis of T lymphocytes in SLE is only a result of abnormal activation and GC treatment may induce the lymphocytes to apoptosis and normalize the ratio of to CD4+/CD8+, which may alleviate the patients' severe symptoms.