类风湿性关节炎患者外周血TH17细胞测定

目的 探讨新的效应T细胞TH17在类风湿性关节炎(RA)患者外周血的分布及意义.方法 选取PHA或PMA+Ion作为刺激剂,建立流式细胞术胞内细胞因子染色的方法,应用该方法检测了35例活动期、30例稳定期RA患者及正常人外周血TH17和TH1细胞百分率.结果 PlVIA+Ion联合刺激的效果优于PHA.RA患者及正常人T细胞经PMA+Ion刺激后,CD3+CD8-T细胞IL-17表达水平较相应未刺激组显著增加(P<0.05).而不论是否加刺激剂,活动期RA患者外周血CD3+CD8-IL-17+细胞明显多于稳定期,二者均多于正常对照组(P<0.05).RA患者外周血TH1细胞呈现与T<,H>17细胞类似的分布特点.结论 活动期RA患者外周血存在TH17细胞的分布异常,T1H17细胞可作为评价RA患者细胞免疫功能状态的新指标.     

TH1／TH2细胞失衡在类风湿关节炎发病中的作用研究进展

辅助性T细胞 (helpTcell,TH)亚群 1和亚群 2 (TH1/TH2 )及其分泌的细胞因子 (Cytokine ,CK)平衡在维持机体的免疫自稳中起重要作用。类风湿关节炎 (RA)存在TH1/TH2 细胞失衡 ,其可能机制包括 :①外周耐受下调 ;②CD2 8,IL 4,IL 12的作用 ;③CC亚族、CXC亚族及其相应受体的作用。恢复TH1/TH2 细胞平衡 ,有望逆转RA病情。     

强直性脊柱炎TH亚群激活及T细胞活化状态研究

目的 :研究强直性脊柱炎 (AS)患者TH1 TH2细胞激活状态及T细胞活化状况 ,探讨其发病机理。方法 :运用流式细胞仪 (CBA)法检测 35例AS患者TH1(INF γ、TNF α、IL 2 )、TH2 (IL 10、IL 5、IL 4 )细胞因子水平以及外周血淋巴细胞CD3 、CD4 、CD8 T细胞、B细胞 (CD19 )、NK细胞 (CD16 5 6 )和CD3 HLA DR 、CD4 HLA DR 、CD8 HLA DR T细胞百分率 ,并与健康对照组比较。结果 :AS患者血浆TNF α水平、IL 2水平均显著低于健康对照组 (P <0 0 1,P <0 0 5 ) ,IL 10水平显著高于健康对照组 (P <0 0 5 )。CD3 、CD3 CD8 T细胞百分率显著低于健康对照。CD8 HLA DR T细胞百分率均显著低于健康对照 (P <0 0 5 ) ,CD4 HLA DR T显著高于健康对照 (P <0 0 5 )。结论 :AS患者血浆低水平的TNF α、IL 2和高水平的IL 10提示其体内存在着TH1 TH2平衡的偏移 ;TH1激活程度低下 ,而TH2激活程度增强 ,细胞因子水平的改变尤以TH1细胞因子TNF α改变特别明显。AS患者在多个层面存在细胞免疫功能紊乱     

川崎病TH1/TH2功能状态的研究

川崎病(Kawasaki disease,KD)是一种急性弥漫性血管炎,婴幼儿发病多见,至今,该病病因及发病机理不明,从病人的流行病学特征推测可能与病原体感染或毒素超抗原引起免疫学异常有关.本研究通过对KD患儿急性期、恢复期PPD皮试的观察以及外周血血清IgE的变化、外周血CD4 T细胞CD30表达和外周血单个核细胞(PBMC)培养上清IL-4、IFN-γ水平的测定,了解KD急性期TH1/TH2功能平衡状态及免疫发病机理.     

类风湿关节炎患者外周血CD4+T细胞亚群的分析

目的 研究类风湿性关节炎(RA)患者不同时期外周血Treg和Th1、Th2、Th17细胞以及中性粒细胞上CD64的表达水平,及它们与RA的活动性指标和自身抗体的相关性.方法 采集78例RA患者和21例健康人外周静脉血,采用流式细胞术检测淋巴细胞亚群(Treg,Th1、Th2、Th17细胞)的变化.结果 RA的CD3+ CD4+T细胞和CD4+ CD25+T细胞增多,活动期RA组Treg比率高于缓解期RA组和健康对照组,缓解期RA组Th2细胞减少,RA中Th1,TH17细胞与健康对照组相比无统计学意义,Treg和Th1、Th2、Th17细胞与RA的活动性指标(ESR,CRP和PLT)均无关联.结论 CD4+T细胞亚群数量异常可能与RA疾病发展有关.     

妊娠高血压综合征发病中免疫调节机制的研究

目的 探讨T细胞表型亚群及TH1/TH2功能亚群在妊娠高血压综合征(妊高征)发病中的免疫调节机制。方法 选择妊高征患者28例及同期分娩的正常健康产妇20例。植物血凝素(PHA)诱导的外周血T细胞表型及TH1型，TH2型细胞因子分别应用流式细胞仪和ELISA法进行检测。结果 与对照组相比，妊高征患者外周血的CD3^ T细胞变化不明显；轻度患者CD4^ T细胞变化不明显，而中、重度患者则增加明显；CD8^ T细胞随病情加重而逐渐减少。妊高征患者IL-2和IFN-γ水平较正常对照组明显升高，其升高程度与病情加重呈正相关；IL-4水平变化不显著，轻度患者的IL-10水平变化不显著，而中、重度患者明显降低。结论 妊高征的发生可能与CD4^ ／CD8^ T细胞比例失调，以及TH1/TH2功能亚群向TH1偏移有关。     

恶性淋巴瘤患者TH 1/TH 2细胞因子表达水平的研究

目的 探讨恶性淋巴瘤患者血清中TH1/TH2细胞因子变化及其临床意义,为肿瘤的免疫治疗提供实验依据.方法 用流式细胞小球微阵列术(cytometric bead array,CBA)检测92例恶性淋巴瘤患者及70例健康人群血清中γ干扰素(IFN-γ)、肿瘤坏死因子-α仪(TNF-α)、白细胞介素(IL-2、IL-4、IL-5、IL-10)表达水平.结果 92例恶性淋巴瘤患者血清中TH1型细胞因子的水平分别为:IFN-γ(34.26±33.4g)pg/ml、TNF-α(8.17±10.09)pg/ml、IL-2(3.74 4±1.72)pg/ml;TH2型细胞因子的水平分别为:IL-10(6.28±8.56)pg/ml、IL-5(3.53±3.20)pg/ml、IL-4(6.22±7.13)pg/ml.除TNF-α表达水平降低外,其余5项均明显高于健康体检组,差异有统计学意义(P＜0.01).TH1细胞因子IL-2与TH2细胞因子IL-4的比值明显下降(0.78±O.44),与健康体检组(1.09±0.45)比较差异有统计学意义(P＜0.01).IL-10与疾病的进展相关,Ⅲ/Ⅳ期恶性淋巴瘤患者的表达水平为(9.58±13.96)pg/ml,Ⅰ/Ⅱ期的表达水平为(4.77±3.50)pg/ml,二者比较差异有统计学意义(P＜0.01).IFN-γ在大于60岁的恶性淋巴瘤患者中表达水平明显降低,与其他年龄段恶性淋巴瘤患者比较差异有统计学意义(P ＜0.05).结论 恶性淋巴瘤患者血清中TH1/TH2细胞因子平衡失调,检测TH1/TH2细胞因子可作为评价淋巴瘤临床进展及预后指标.TH1/TH2平衡向TH2方向漂移,这可能是肿瘤细胞发生免疫逃逸,从而导致肿瘤的发生或者转移的原因之一.     

胃癌患者外周血TH1/TH2细胞因子水平的观察

胃癌是当今世界范围内在发病和死亡中最常见的恶性肿瘤之一,严重威胁着人类的健康.我们应用流式细胞仪检测胃癌患者外周血CD4+T细胞中TH1/TH2细胞因子的水平,探讨胃癌患者体内TH1/TH2细胞的反应状态,为胃癌的免疫治疗提供实验依据.     

类风湿性关节炎患者外周血Th17/Treg细胞比率失衡的研究

目的:观察类风湿性关节炎(RA)患者外周血Th17细胞与Foxp3+CD4+CD25+调节性T(Treg)细胞的平衡状态与疾病状态的关系,初步阐明Th17/Treg细胞比率失衡在RA发病机制中的作用和意义。方法:流式细胞术(FCM)检测RA患者和健康人外周血中Th17细胞和Foxp3+CD4+CD25+Treg细胞的比率。结果:活动期RA患者外周血CD3+CD4+T细胞和Th17细胞的比率均明显高于健康对照组(P均0.05);而Foxp3+CD4+CD25+Treg细胞的比率明显低于健康对照组(P0.05)。随疾病活动性的增加,Th17细胞表达增高(P0.05);而Foxp3+CD4+CD25+Treg细胞表达降低,但无统计学意义(P0.05)。结论:RA患者外周血T细胞紊乱以CD4+T细胞的增加为主,Th17细胞比率的增加和Foxp3+CD4+CD25+Treg细胞比率的降低所致的Th17/Treg细胞比率失衡,可能在RA的发生发展中起重要作用。     

脂多糖肺损伤CD4~+T细胞及其亚型T_(H1)、T_(H2)细胞的凋亡

目的　观察CD4 + T细胞及其亚型TH1 、TH2 细胞的凋亡变化 ,从TH1 、TH2 凋亡的角度探讨脂多糖肺损伤时机体抗炎、致炎反应的分子机制。方法　静脉注射脂多糖制作大鼠脂多糖肺损伤模型。分离、提纯外周血与BALF中T淋巴细胞 ,抗大鼠CD4 FITC标记、流式细胞仪分选后 ,通过流式细胞仪检测及荧光显微镜检查 ,观察外周血与BALF中CD4 + T淋巴细胞凋亡变化 ;应用免疫组织化学技术及TUNEL法双染动态观察外周血与BALF中TH1 、TH2 细胞凋亡的变化。结果　①脂多糖 (LPS)致伤后 ,外周血与BALF中CD4 + T淋巴细胞进行性减少 ,与正常对照组比较差异非常显著 ,与该类细胞凋亡比例之间呈显著负相关关系 ,提示CD4 + T细胞呈时间依赖性凋亡性减少。地塞米松 (DEX)组与LPS组比较 ,CD4 + T细胞比例及凋亡百分数无显著差异 ;②LPS致伤后 ,外周血与BALF中IFN γ阳性细胞 (TH1 细胞 )与IL 4阳性细胞 (TH2 细胞 )数目均减少 ,与各自凋亡细胞的比例呈显著的负相关关系。DEX组IFN γ阳性细胞、IL 4阳性细胞数目均减少 ,IFN γ阳性细胞中凋亡细胞的百分数明显增加 ,与对照组比较差异非常显著 (P <0 .0 1)。IL 4阳性细胞中凋亡细胞的百分数亦增加 ,但幅度小于IFN γ阳性细胞。LPS致伤后 ,大鼠肺组织水肿及炎性病变程度进行性加重 ,     

Relationship of CD146 expression to secretion of interleukin (IL)‐17, IL‐22 and interferon‐γ by CD4+ T cells in patients with inflammatory arthritis

Expression of the adhesion molecule, CD146/MCAM/MelCAM, on T cells has been associated with recent activation, memory subsets and T helper type 17 (Th17) effector function, and is elevated in inflammatory arthritis. Th17 cells have been implicated in the pathogenesis of rheumatoid arthritis (RA) and spondyloarthritides (SpA). Here, we compared the expression of CD146 on CD4⁺ T cells between healthy donors (HD) and patients with RA and SpA [ankylosing spondylitis (AS) or psoriatic arthritis (PsA)] and examined correlations with surface markers and cytokine secretion. Peripheral blood mononuclear cells (PBMC) were obtained from patients and controls, and synovial fluid mononuclear cells (SFMC) from patients. Cytokine production [elicited by phorbol myristate acetate (PMA)/ionomycin] and surface phenotypes were evaluated by flow cytometry. CD146⁺CD4⁺ and interleukin (IL)‐17⁺CD4⁺ T cell frequencies were increased in PBMC of PsA patients, compared with HD, and in SFMC compared with PBMC. CD146⁺CD4⁺ T cells were enriched for secretion of IL‐17 [alone or with IL‐22 or interferon (IFN)‐γ] and for some putative Th17‐associated surface markers (CD161 and CCR6), but not others (CD26 and IL‐23 receptor). CD4⁺ T cells producing IL‐22 or IFN‐γ without IL‐17 were also present in the CD146⁺ subset, although their enrichment was less marked. Moreover, a majority of cells secreting these cytokines lacked CD146. Thus, CD146 is not a sensitive or specific marker of Th17 cells, but rather correlates with heterogeneous cytokine secretion by subsets of CD4⁺ helper T cells.     

A preliminary study on the characterization of follicular helper T (Tfh) cells in rheumatoid arthritis synovium

Rheumatoid arthritis (RA) is a chronic and systematic autoimmune inflammatory disease. Recently, a novel T cell subset, follicular helper CD4 T cell (Tfh cells) was found in relation to the pathogenesis and progression of RA, and increased numbers of circulating Tfh cells were found in RA patients. However, there is little evidence regarding the localization of Tfh cells in synovium tissues from RA patients, owing to the lack of an available method to characterize their localization in tissue. The aim of our present study was to characterize the Tfh cells in rheumatoid synovium tissues from RA patients by using immunohistochemistry and triple-fluorescence immunostaining methods. Our results showed that specific staining of CD4, CXCR5 and ICOS could be found on infiltrating immune cells in rheumatoid synovium tissues. The use of triple-fluorescence immunostaining and confocal laser scanning showed immunolocalization of CD4⁺CXCR5⁺ICOS⁺T cells (Tfh cells) in the rheumatoid synovium tissues, whereas these signals were absent in osteoarthritis (OA) synovium and in normal synovium tissues. Thus the data from our present preliminary study support the notion that CD4⁺CXCR5⁺ICOS⁺Tfh cells could be found in rheumatoid synovium tissues from RA patients, indicating the possibility that this T cell subset in synovium tissues may have important roles in the pathogenesis and progression of RA.     

淋巴细胞共刺激信号和凋亡信号异常与RA免疫效应亢进的研究

目的：探究T淋巴细胞表面多种细胞信号分子所介导的细胞活化或凋亡信号在RA患者免疫功能紊乱中的作用。方法：采用流式细胞术检测RA患者外周血T细胞亚群及其表面共刺激分子cD154（cD40L）、CD30和凋亡受体CD95（Fas）的表达。结果：RA患者外周血T细胞亚群偏移，CD4^＋T细胞增加，CD8^＋T细胞减少；共刺激分子CD154在CD4^＋和CD8^＋T细胞上的表达均上调，但CD30分子的表达均降低，并以CD4^＋T细胞降低更为明显。同时，凋亡受体CD95分子在T细胞亚群上的表达均明显增加。结论：RA患者T淋巴细胞表面多种信号分子表达异常，共同导致了RA患者免疫功能紊乱。     

The effect of anti-CD4 on helper function of CD4,45RA+ versus CD4,45RO+ T cells.

Here we have investigated and compared the effects of anti-CD4 on helper function of CD4,45RA+ versus CD4,45RO+ T cells. Only CD4,45RO+ cells, but not CD4,45RA+ cells were able to promote B cell differentiation resulting in immunoglobulin production in vitro (IgM as well as IgG) which could be inhibited by anti-CD4 MoAbs (MAX.16H5 and T151). In pokeweed mitogen (PWM)-induced B cell proliferation a similar pattern of responsiveness was obtained. When we studied the anti-CD4 effects on cytokine production in T cells stimulated in mixed lymphocyte reaction (MLR) or by mitogens, we found that neither IL-2 nor IL-4 production was dramatically influenced by anti-CD4 in CD4,45RO+ cells. This led us to the conclusion that the inhibitory effect of anti-CD4 on B cell proliferation and immunoglobulin secretion was not due to inhibition of cytokine production. To clarify this point, we investigated the ability of anti-CD4 to inhibit conjugate formation between B and T cells. It was found that CD4,45RO+ T cells formed more conjugates than CD4,45RA+ cells, and that only the conjugate formation by CD4,45RO+ T cells was inhibited by anti-CD4. These results suggest that (i) anti-CD4 inhibits T helper functions primarily by affecting CD4,45RO+ cells, and (ii) this effect is probably mediated by contact inhibition in the early phase of T-B collaboration.     

Abnormal distribution of the helper-inducer and suppressor-inducer T-lymphocyte subsets in the rheumatoid joint

T lymphocytes can be divided into two main phenotypic populations, CD4 and CD8. These can be further subdivided into 2H4, 4B4, or UCHL1 subsets by appropriate monoclonal antibodies. We have investigated these subsets in the synovial fluid of patients with rheumatoid arthritis and have found (i) a virtual absence of CD4+ 2H4+ and the marked reduction of CD8+ 2H4+ T cells; (ii) a marked increase of CD4+ 4B4+ and CD8+ 4B4+ T cells; and (iii) a marked increase of CD4+ UCHL1+ and CD8+ UCHL1+ T cells compared with peripheral blood. Although the functions of the CD8 subsets are not known, the virtual absence of CD4+ 2H4+ suppressor-inducer T cells and the marked increase of CD4+ 4B4+ helper-inducer T cells and of CD4+ UCHL1+ memory T cells may help to explain the many known functional immunological properties of synovial T cells.     

T-Cell Immune Imbalance in Rheumatoid Arthritis Is Associated with Alterations in NK Cells and NK-Like T Cells Expressing CD38

BackgroundCD38+ NK (CD3− CD16+ CD38+ CD56+) cells were increased in rheumatoid arthritis (RA), which suppressed Treg cell differentiation. This study explored how CD38+ NK cells regulated CD4+ T-cell differentiation into Treg cells in RA.MethodsProportions of CD38+ NK cells and their counterpart CD38+ NK-like T (CD3+ CD16+ CD38+ CD56+) cells were measured in RA and rats with collagen-induced arthritis (CIA). CD38+ NK cells and CD38+ NK-like T cells were cocultured with CD4+ T cells, respectively.ResultsA significantly increased proportion of CD38+ NK cells and a decreased proportion of CD38+ NK-like T cells were detected in RA and CIA blood and synovial fluids. When CD4+ T cells were cocultured with CD38+ NK cells, mammalian target of rapamycin (mTOR) signaling was activated, and Th1/Th2 and Th17/Treg ratios were increased. When CD38+ NK cells were pretreated with anti-CD38 antibody, Treg cell proportion was increased, and Th1/Th2 and Th17/Treg ratios were decreased. CD38+ NK-like T cells showed the opposite results. CD38+ NK cells and CD38+ NK-like-T cells activated differential gene expressions and pathways in CD4+ T cells and initiated Th1 and Th2 cell differentiation by differential gene nodes.ConclusionsThis study suggest that the high CD38+ NK cell proportion and low CD38+ NK-like T cell proportion in RA suppress Treg cell differentiation by stimulating mTOR signaling in CD4+ T cells, which consequentially disturbs the immune tolerance.     

IL-4 down-regulates the surface expression of CD5 on B cells and inhibits spontaneous immunoglobulin and IgM-rheumatoid factor production in patients with rheumatoid arthritis.

There is evidence to suggest that CD5+ B cells may be associated with autoimmunity, e.g. they are increased in patients with rheumatoid arthritis (RA). In this study, we found that the expression of CD5 on RA B cells increased spontaneously, following culture for up to 4 days in vitro in the absence of T cells, supporting the idea that the CD5+ B cell possesses distinctive features. The spontaneous increase of CD5 expression was down-regulated by recombinant IL-4 (rIL-4). Other cytokines studied (rIL-1 alpha, rIL-2, rIL-5, rIL-6) did not alter CD5 expression. Studies of antibody production showed that rIL-4 could reduce spontaneous production of total IgG and IgM in non-stimulated RA T plus B cell cultures. Spontaneous production of IgM rheumatoid factor (IgM-RF), measured by a newly developed avidin-biotin complex ELISA, was also reduced by rIL-4. Furthermore, rIL-4 reduced the increase in IgM-RF production observed on stimulation with Staphylococcus aureus Cowan I (SAC) or pokeweed mitogen (PWM). Thus, IL-4 might act as a regulator of the development of abnormal B cell differentiation in patients with RA.     

Regulatory T cells in patients with systemic lupus erythematosus

Regulatory T cells have an important role in the control of self-reactivity, and in the pathogenesis of autoimmune inflammatory conditions. The aim of this work was to perform a quantitative and functional analysis of regulatory T cells in patients with systemic lupus erythematosus (SLE). We studied twenty-three patients with SLE (19 active, 4 inactive), and twenty-seven healthy subjects as well as fifteen patients with rheumatoid arthritis (RA). The following cell subsets were analyzed in peripheral blood mononuclear cells by flow cytometry: CD4+CD25+, CD4+CD25(bright), CD4+Foxp3+ (Treg cells), CD8+CD28- (Ts cells), CD4+IL-10+ (Tr1 cells), and CD4+TGF-beta+ (Th3 cells). In addition, the in vitro suppressive activity of CD4+CD25+ lymphocytes was tested. We found no significant differences in the levels of all regulatory cell subsets studied in SLE patients compared to controls and RA patients. However, a defective regulatory function of CD4+CD25+T cells was observed in a significant fraction (31%) of patients with SLE. Our data indicate that although approximately one third of patients with SLE show an abnormal immunosuppressive function of Treg lymphocytes, their levels of the different regulatory T cell subsets in peripheral blood are not significantly different from those found in controls.     

共刺激分子CD40L在RA患者T细胞亚群中的异常表达

目的　探讨共刺激分子CD4 0L在类风湿关节炎 (RA)患者的T细胞亚群上的表达异常与免疫功能紊乱的关系。方法　用流式细胞仪采用直接免疫荧光法测定 4 6例RA患者和 2 0例健康对照人外周血T细胞表面标志CD3、CD4、CD8的表达情况及CD4 0L在CD4 + T和CD8+ T细胞上的表达。用IMMAGE免疫分析仪 ,速率散射比浊法测定血清中免疫球蛋白的水平。结果　RA患者CD3+ CD4 + 细胞较正常对照组显著增高 (P <0 .0 5 ) ,CD3+ CD8+ 细胞较正常对照组显著降低 (P <0 .0 5 ) ,CD4 + T细胞和CD8+ T细胞上的CD4 0L的表达都较对照组显著增高 (P <0 .0 5 ) ;血清中 3种免疫球蛋白IgG、IgA、IgM的水平均较对照组显著增高 (P <0 .0 5 )。结论　RA患者以CD4 + T细胞活化为主 ,CD4 + T细胞和CD8+ T细胞上高表达的CD4 0L为T细胞活化提供第二信号 ,促使RA患者的细胞免疫功能亢进 ,同时诱导B细胞增生 ,产生大量免疫球蛋白。CD4 0 CD4 0L途径在RA免疫功能紊乱中起了重要作用     

Expression of Activation Markers on CD4+ and CD8+ Cells from Synovial Fluid, Synovial Tissue, and Peripheral Blood of Patients with Inflammatory Arthritides

We studied the expression of the Tac antigen, the transferrin receptor (Tfr-R), HLA class II antigens (DR, DQ, DP), CD30, and Act 1 on purified CD4+ and CD8+ cells isolated from synovial fluid (SF), synovial tissue (ST), and peripheral blood (PB) of patients with rheumatoid arthritis (RA) and with non-RA inflammatory arthritides (not ST). Subfractionated T cells of PB from healthy individuals served as controls. SF CD4+ cells from RA and non-RA arthritides expressed the Tac antigen much more frequently than corresponding CD8+ cells (54 and 58% versus 16 and 17%). In contrast, SF CD8+ cells of both patient groups expressed the HLA class II antigens rather more frequently than the corresponding CD4+ cells (88 and 68% versus 72 and 40%). Tfr-R expression was low on CD4+ and CD8+ SF T cells from both patient groups. SF T cells did not express CD30, and their expression of Act 1 did not differ from that of normal PB T cells. The RA ST findings were similar to those of RA SF. The overall expression of activation markers on PB T cells of patients was slightly higher than on those of normal controls, and the RA group was slightly higher than the non-RA group. The results show that intra-articular T cells in arthritis are activated and that CD4+ and CD8+ subsets differ in their expression of Tac antigen and HLA class II antigens. There were also similar patterns of activation markers on both CD4+ and CD8+ SF cells from RA and non-RA arthritis patients, suggesting that several types of arthritis display a similar immunopathogenesis in the joints.