CD154在活动期系统性红斑狼疮B淋巴细胞中的表达

目的探讨CD154在系统性红斑狼疮(SLE)中的异常表达及其在狼疮发病中的作用机制。方法16例活动期SLE及14名正常健康人,分离外周血CD19阳性B细胞,以流式细胞仪荧光抗体标记检测其CD154的表达,并体外观察抗CD154抗体对外周血B细胞的增生及IgG分泌的影响。结果①活动期SLE外周血B淋巴细胞中CD154阳性率(36±17)%及表达强度(364±238)均显著高于正常健康人,后者分别为(10±8)%,124±97%(P均<0.001);②体外单独培养,活动期SLE外周血B淋巴细胞自身即可异常增生并分泌IgG,[3H]-TdR掺入及体外培养上清液IgG浓度与正常人相比,差异有显著性(P值分别<0.0001和0.001)。抗CD154抗体可显著抑制活动期SLE外周血B淋巴细胞的异常增生及IgG的异常分泌,[3H]TdR掺入及体外培养上清液IgG浓度与对照抗体组相比,差异有显著性(P值分别为0.027和0.034)。结论CD154在活动期SLE的B淋巴细胞中有异常表达,其异常调控可能是导致分泌自身抗体B细胞克隆增生的主要原因。     

系统性红斑狼疮患者CD5+B细胞的测定和意义

目的探讨外周血中CD5 B细胞在系统性红斑狼疮(SLE)活动中的作用及相关性。方法利用流式细胞分析法对57例SLE患者和35名正常人群外周血CD5~ B细胞进行检测,并且同时检测抗dsDNA抗体、抗核抗体(ANA)、抗心磷脂抗体(ACL)、补体C3、C4。结果SLE患者CD5~ B细胞水平[(2．1 0．4)%]与正常人[(1．5±0．4)％]比较差异有统计学意义(P＜0．05),活动期SLE患者CD5~ B细胞水平(2．5±0．5)％显著高于稳定期(1．4±0．5)％；CD5 B细胞与dsDNA、ANA、抗心磷脂抗体(ACL)升高呈正相关,与补体c3呈负相关。结论系统性红斑狼疮患者外周血CD5~ B细胞明显升高,与SLE疾病活动有一定关系。     

应用TaqMan实时荧光定量PCR技术研究系统性红斑狼疮疾病相关基因的表达

目的验证新发现的4个系统性红斑狼疮(SLE)相关基因与SLE发病的相关性,为SLE发病的分子机制研究提供资料。方法前期基因芯片工作中筛选得到4个在55例SLE患者及正常对照之间表达差异显著的基因,染色体定位发现其位于SLE连锁的染色体区段。应用TaqMan实时荧光定量聚合酶链反应(PCR)技术检测该4种基因在SLE患者和正常对照外周血单核细胞及T、B淋巴细胞的表达。结果SLE患者外周血单核细胞中,TRIM基因ΔCt值显著低于正常人对照(P＜0．05),基因表达水平为正常对照的0．61倍；IL-4R基因与EGR1基因的ΔCt值显著高于正常人对照(P＜0．05),基因表达水平分别为正常对照的2．62、2．03倍；KLRC1基因的ΔCt值显著高于正常人对照(P＜0．01),基因表达水平为正常对照的5．33倍。在SLE患者外周血T细胞,TRIM基因ΔCt值显著低于正常人对照(P＜0．01),基因表达水平为正常对照的0．56倍；IL-4R基因与EGR1基因的ΔCt值显著高于正常人对照(P＜0．05),基因表达水平分别为正常对照的2．55、1．74倍；KLRC1基因的ΔCt值显著高于正常人对照(P＜0．01),基因表达水平为正常对照的5．19倍。在SLE患者外周血B淋巴细胞,由于B细胞淋巴所占淋巴细胞比率过低,基因检测数据不稳定,故未作统计学分析。4种狼疮疾病相关基因与狼疮活动指数SLEDAI无相关性。结论SLE患者TRIM,IL-4R,KLRC1和EGR1基因与正常人相比有明显差异,但与疾病活动程度无关。     

系统性红斑狼疮患者外周血CD4+ CD8+和CD22+淋巴细胞活化分子CD69的表达

目的探讨系统性红斑狼疮(SLE)患者外周血淋巴细胞(PBL) T细胞(CD4+、CD8+)和B细胞(CD22+)活化分子CD69的表达.方法应用双染色流式细胞术检测CD4、CD8、和CD22细胞亚群CD69分子;在植物凝集素(PHA)刺激后20 h淋巴细胞亚群CD69分子的表达.结果①SLE患者PBMC的CD69分子活动期高于静止期(P＜0.001)和正常对照组(P＜0.01)的表达,SLE静止期患者与正常对照组CD69表达差异无显著性(P＞0.05).②进一步分析CD4+、CD8+和CD22+淋巴细胞亚群的CD69的表达,其中,SLE活动期患者CD4+细胞的CD69表达显著高于静止期(P＜0.001)和正常对照组(P＜0.01)的表达,SLE静止期患者与正常对照组CD69表达差异无显著性(P＞0.05);CD8+细胞活动期高于静止期患者(P＜0.05),其余组间差异无显著性(P＞0.05);CD22+B细胞各组间差异无显著性.③PHA刺激20 h后,CD4+、CD22+B细胞的CD69表达,活动期显著高于静止期患者和正常对照组(P＜0.01).结论 SLE患者外周血CD4+T细胞和CD22+B细胞存在着异常的活化,这种淋巴细胞的异常活化是SLE重要的发病机制之一.     

类风湿关节炎患者外周血B淋巴细胞共刺激分子的表达及其意义

目的 初步探讨类风湿关节炎(RA)患者免疫功能紊乱的机制。方法 采用流式细胞仪检测RA患者外周血B淋巴细胞共刺激分子CD80、CD86、CD40的表达并用ELISA检测RA患者血清和关节滑膜液中Th1细胞分泌的细胞因子白细胞介素(IL)-2、干扰素-γ和Th2细胞分泌的细胞因子IL-6、IL-10的水平。结果 RA患者外周血B淋巴细胞CD86表达比正常对照组明显下降(P＜0．01),B淋巴细胞CD40表达比正常对照组明显增多(P＜0．05),而B淋巴细胞CD80表达与正常对照组之间差异无显著性(P＞0．05),同时RA患者血清及滑膜液中IL-2、干扰素-γ的水平比正常对照组明显升高(P＜0．01或P＜0．05),而IL-6、IL-10的水平降低(P＜0．01或P＜0．05)。结论 B淋巴细胞共刺激分子CD86、CD40的异常表达可能与RA患者Th1／Th2细胞分泌的细胞因子失衡密切相关,这将为临床治疗RA提供新的思路。     

系统性红斑狼疮B细胞中CDl54诱导转录因子NF-kB核转移异常的研究

目的对配体CDl54在系统性红斑狼疮(SLE)患者B淋巴细胞中刺激转录因子NF—kB核转移的异常进行研究。方法分离正常人对照、SLE患者外周血B淋巴细胞及扁桃体生发中心B淋巴细胞，并以后者为参照，观察与正常人对照相比，SLE外周血B淋巴细胞中CDl54和抗CDl54抗体对NF—kB核转移或基础活化的影响。结果①正常人外周血B细胞CD154刺激主要诱导NF—kB亚单位p50、p65及c—Rel进入细胞核，而SLE外周血B细胞与扁桃体B细胞相似．刺激前细胞核内功能性p50和c—Rel基础值即高于正常人对照，CDl54刺激只进一步诱导p65进入细胞核；②抗CD154抗体可抑制SLE外周血CD154高表达的B细胞核中p65和c—Rel的基础活化值，亦与扁桃体B细胞相似。结论与正常人对照相比，SLE外周血B淋巴细胞中CD154诱导NF—KB核转移存在显着异常，类似生发中心表型．     

系统性红斑狼疮患者T细胞TCR/CD3复合物介导的信号传导研究

目的：证实系统性红斑狼疮（SLE）患者T细胞功能异常是否与其生物化学信号传导异常有关。方法：用CD3单抗与羊抗鼠二抗IgG相交联刺激T细胞并用Thapsigargin和依地酸（EGTA）干预后，分别用粘附细胞仪连续观察10min T细胞[Ca^2 ]i的变化，并评价[Ca^2 ]i反应与CD3分子和三磷酸肌醇（InsP3）生成量的相关性。结果：正常人和SLE患者T细胞[Ca^2 ]i反应的基准值相似（P＝0．105）；SLE患者高峰者，平台值T细胞的[Ca^2 ]i反应明显高于正常对照（P＜0．001，P＜0．001），加入Thapsigargin后二者[Ca^2 ]i反应差异无显著性，而加入EGTA后二者[Ca^2 ]i反应差异有显著性，二者的T细胞CD3阳性率和InsP3生成量差异无显著性（P＝0．665，P=0．537）。结论：SLE患者T细胞TCR／CD介导的信号传导途径存在异常，SLE患T细胞功能异常可能是因细胞内生物化学信号传导途径异常所致。     

特发性血小板减少性紫癜患者外周血淋巴细胞协同刺激分子B7的表达

目的　探讨B淋巴细胞表面协同刺激分子B7(B7 1、B7 2 )在特发性血小板减少性紫癜 (ITP)中的变化。方法　用流式细胞术检测 30例初发ITP患者和 15例正常人对照外周血淋巴细胞协同刺激分子B7 1(CD80 + )、B7 2 (CD86 + )表达率。结果　ITP患者外周血淋巴细胞CD86 + 、B细胞表面CD86 (CD1 9+ CD86 + CD1 9+ )表达率明显高于正常人 (P <0 .0 5 ) ,而CD80 + 、CD1 9+ CD80 + CD1 9+ 表达率相对于正常人无显著性差异 (P >0 .0 5 )。结论　ITP患者CD86 + 的改变可能参与ITP自身免疫的病理机制     

趋化因子及受体变化与初发系统性红斑狼疮免疫异常的相关性研究

目的初步探讨趋化因子及受体与初发系统性红斑狼疮(SLE)免疫异常的相关性。方法采用酶联免疫吸附试验(ELISA)检测37例初发SLE患者和20名正常对照的巨噬细胞炎症蛋白-la (MIP-1α)、MIP-1β、激活正常T细胞表达和分泌因子(RANTES)以及γ干扰素(IFN-γ)和白细胞介素-4 (IL-4)的血清水平,用流式细胞术检测其中18例初发SLE患者及10名正常对照外周血CD4~ T细胞表面趋化因子受体(CCR)1、CCR3、CCR5的表达情况,分析它们的相关性。结果初发SLE血清MIP-1α、MIP-1β水平较健康对照显著升高(P＜0．01),MIP-1α和MIP-1β呈显著正相关(r=0．609,P＜0．01)；初发SLE组的CD4~ CCR1~ 、CD4~ CCR5~ 细胞百分率显著低于对照组(P均＜0．01),CD4~ CCR1~ 细胞百分率与血清MIP-1α、IFN-γ水平呈显著负相关(r=-0．525,P=0．017；r=-0．442,P=0．045)；CD4~ CCR5~ 细胞百分率与血清IFN-γ水平呈显著负相关(r=-0．645,P=0．001)；CD4~ CCR3~ /CD4~ CCR5~ 比值显著高于对照组(P＜0．01)。结论趋化因子及其受体与细胞因子间相互影响,它们的异常改变可能导致机体免疫紊乱,参与SLE发病。     

系统性红斑狼疮患者外周血CD4+CD25+T细胞亚群的表达及临床意义

目的研究系统性红斑狼疮(SLE)患者外周血CD4~ 、CD25~ 、CD4~ CD25~ 淋巴细胞亚群的变化及临床意义。方法采用二色荧光抗体标记法,以流式细胞仪对34例SLE患者和18名正常人外周血CD4~ 、CD25~ 、CD4~ CD25~ 淋巴细胞亚群进行了检测,以CD25抗原荧光强度≥10的细胞定义为CD25~(high)细胞,分析其百分率和荧光强度,并结合临床资料进行相关分析。结果活动组SLE患者外周血CD4~ CD25~ 细胞、CD4~ CD25~(high)细胞占总淋巴细胞的百分率[(4．80±1．21)%和(0．25±0．10)%]均低于正常对照组[(8．92±3．21)%和(0．44±0．22)%],亦低于稳定组SLE患者[(11．28±2．09)%和(0．59±0．34)%](P均＜0．05),而稳定组SLE患者与正常对照组差异无统计学意义(P＞0．05)；但CD4~ CD25~ 细胞占CD4~ 细胞的比例在三组之间差异无统计学意义(P均＞0．05)；外周血CD4~ CD25~ 、CD4~ CD25h~(high)细胞数与系统性红斑狼疮疾病活动指数(SLEDAI)积分呈负相关(r=-0．74,P=0．004和r=-0．614,P=0．026),与其他临床指标如补体、抗核抗体(ANA)滴度等无相关性；活动组SLE患者外周血CD4~ 和CD25~ 细胞亦均低于正常对照组[(23±7)vs(34±7)和(7．4±1．8)vs(13．9±3．4),P＜0．05]；SLE患者CD25抗原的荧光强度高于正常对照组(P＜0．05),而CD4抗原的荧光强度差异无统计学意义(P＞0．05)。结论活动性SLE患者外周血CD4~ CD25~ 细胞数是减少的,并与CD4~ 细胞的减少有关,提示在SLE的发病及病情活动中可能起一定作用。     

系统性红斑狼疮患者外周血单个核细胞CD28 mRNA的表达

目的　探讨CD28在系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中的表达水平及其意义。方法　应用反转录-聚合酶链反应(RT-PCR)检测了34例活动期SLE患者和30名正常人PBMC中CD28mRNA的表达水平。结果　活动期SLE患者CD28的阳性表达率为20.6%,明显低于正常人对照组(70.0%),差异非常显著(P＜0.001);活动期SLE组CD28的平均表达水平(0.19±0.21)亦明显低于正常对照组(0.43±0.11),差异显著(P＜0.05)。结论　CD28的异常表达可能在SLE发病机制中起作用,CD28mRNA的低水平表达可能与外周血CD28＋T细胞凋亡增加或迁移到炎症部位有关。     

间充质干细胞对系统性红斑狼疮CD4+Foxp3+T淋巴细胞的调节

目的 探讨同种异体骨髓间充质干细胞(MSC)体内外对系统性红斑狼疮(SLE)患者外周血CD4+Foxp3+T淋巴细胞及人脐带MSC移植对MRL/lpr鼠脾脏和淋巴结CD4+Foxp3+T淋巴细胞水平的影响.方法 血缘相关供者骨髓中分离培养MSC移植治疗5例SLE患者,采用流式细胞术检测移植前后外周血CD4+Foxp3+T淋巴细胞百分率.7例SLE患者外周血单个核细胞(PBMC)分别与SLE患者和正常人骨髓MSC按不同比例体外共培养72 h,检测共培养后PBMC中CD4+Foxp3+T淋巴细胞百分率.MRL/Ipr鼠输注脐带MSC后检测脾脏和淋巴结CD4+Foxp3+T淋巴细胞百分率.结果 SLE患者异基因骨髓MSC移植后1周外周血CD4+Foxp3+T淋巴细胞百分率(4.8±1.6)%和移植后3个月(6.0±2.6)%均较移植前(2.1±1.2)%明显升高(5例,P<0.05).正常骨髓MSC与SLE患者PBMC共培养后CD4+Foxp3+T淋巴细胞百分率明显升高(P<0.05).且存在剂量依赖性,狼疮MSC也可上调SLE患者CD4+Foxp3+T淋巴细胞水平,但作用较正常MSC弱(P<0.05);正常MSC培养上清也可上调SLE患者PBMC中CD4+Foxp3+T淋巴细胞水平,但作用弱于MSC:PBMC=1:1组(P<0.05).MRL/Ipr鼠经1次或3次脐带MSC移植后脾脏CD4+Foxp3+T淋巴细胞百分率均较对照组高(P<0.05),但淋巴结CD+Foxp3+T淋巴细胞百分率均较对照组低(p<0.01),1次和3次移植组间差异无统计学意义.结论 异基因甚至异种MSC移植可上调SLE患者或MRL/Ipr鼠CD4+Foxp3+T淋巴细胞水平,同时体外试验也得出相同结论,且体外上调作用呈一定剂量依赖性,CD4+Foxp3+T淋巴细胞水平上调可能是MSC移植治疗SLE有效的机制之一.     

Prolactin enhances the in vitro production of IgG in peripheral blood mononuclear cells from patients with systemic lupus erythematosus but not from healthy controls

OBJECTIVES: Recent evidence suggests that prolactin (PRL) plays a part in the pathogenesis of systemic lupus erythematosus (SLE). Because B cell hyperreactivity and autoantibodies are characteristic hallmarks of SLE, this study aimed at assessing the impact of this pituitary hormone on IgG production by stimulating peripheral blood mononuclear cells (PBMC) with PRL. METHODS: PBMC from 11 patients with SLE assessed by the ECLAM score and eight healthy controls were incubated with PRL and cultured for seven days. IgG production was measured by enzyme linked immunosorbent assay (ELISA). RESULTS: Spontaneous IgG production of SLE PBMC was significantly enhanced compared with that found in healthy controls. After PRL stimulation, the IgG concentrations of supernatants from SLE PBMC were significantly higher than those of unstimulated PBMC (median 394 ng/ml). Of note, the physiological concentration of PRL (20 ng/ml) induced IgG production more effectively (median 1139 ng/ml) than PRL at 100 ng/ml (median 1029 ng/ml). In contrast, preincubation with PRL did not stimulate IgG production in normal PBMC. A significant correlation between PRL induced IgG production and the disease activity (ECLAM) of the patients with SLE was seen. Moreover, the maximum amount of PRL induced IgG depended on the serum PRL concentrations of the patients with SLE. CONCLUSIONS: The results suggest that PBMC from patients with SLE have an extraordinarily high susceptibility to PRL, showing the most striking effect at a concentration usually found in vivo. This indicates a potential role for mild hyperprolactinaemia in the pathogenesis of SLE, influencing both IgG production and disease activity.     

系统性红斑狼疮患者外周血CD4+CD25highFoxp3+调节性T细胞数量和Foxp3mRNA的表达水平与疾病活动性的相关性

目的 研究系统性红斑狼疮(SEE)患者CD4+CD25highFoxp3+调节性T细胞的数量及其功能基因Foxp3 mRNA的表达水平与SLE疾病活动性和肾脏损伤的相关性.方法 采用四色流式细胞术以Foxp3-异硫氰酸荧光素(FITC )/CD25-藻红蛋白/CD4-多甲藻叶绿素蛋白(PerCP)/CD3-藻蓝蛋白7抗体组合检测40名健康对照者及42例SLE患者外周血CD4+CD25highFoxp3+调节性T细胞的数量,实时荧光定量聚合酶链反应(PCR)检测特异性转录因子Foxp3 mRNA的表达水平,并分析其与SLE患者疾病活动指数(SLEDAI)、补体C3及血清抗双链DNA(dsDNA)抗体的关系.统计学方法采用t检验和Spearman相关分析.结果 活动期SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量显著低于健康对照组[(4±3)％与(7±4)％,P＜0.05],稳定期与健康对照组差异无统计学意义(P＞0.05);活动期SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量及CD4+CD25highFoxp3+调节性T细胞/CD4+比值显著低于稳定期患者[(4±3)％,(9±6)％与(5±4)％,(10±6)％,P均＜0.05];活动期SLE患者外周血Foxp3 mRNA的表达水平明显低于稳定期和对照组(P＜0.01,P＜0.05);SLE患者并发肾病组外周血CD4+CD25highFoxp3+调节性T细胞数量及CD4+CD25highFoxp3+调节性T细胞/CD4+比值显著低于SLE非肾病组(P＜0.05).相关分析显示,SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量与SLEDAI呈负相关(r=-0.5782,P＜0.05);CD4+CD25highFoxp3+调节性T细胞/CD4+比值与SLEDAI呈负相关(r=-0.4913,P＜0.05),与补体C3呈正相关(r=0.3687,P＜0.05);SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量与Foxp3 mRNA的表达水平呈正相关(r=0.6142,P＜0.0l).结论 SLE患者外周血CD4+CD25highFoxp3+调节性T细胞和Foxp3 mRNA的变化可能是导致SLE疾病发生和发展的关键因素之一,与疾病的活动性有密切关系.     

Increased antiplatelet T helper lymphocyte reactivity in patients with autoimmune thrombocytopenia.

Chronic autoimmune thrombocytopenic purpura (ATP) is a common hematologic disorder in which platelet-specific autoantibodies bind to platelets and enhance their destruction by the reticuloendothelial system. While there has been considerable investigation of the humoral immune abnormalities in ATP, little work has been performed on the cellular immunoregulatory aspects of this autoimmune disorder. We describe here that patients with ATP have lymphocytes that proliferate normally when stimulated by mitogens. However, when stimulated by normal control platelets in 7-day antigen-presenting cell cultures, peripheral blood mononuclear cells (PBMC) from patients with ATP proliferate at significantly higher levels (P less than .001) and their lymphocytes secrete significantly higher amounts of interleukin-2 (IL-2) (P less than .001) than do lymphocytes from control subjects. Depletion studies with monoclonal anti-CD8 and complement did not reduce the proliferative capacity of the responding PBMC population, indicating that CD4+ T-helper cells may be responsible for the response. Phenotypic analysis of peripheral blood lymphocyte subsets from patients with ATP showed that there was a significant reduction in CD4+Leu8+ T suppressor-inducer cells (P less than .001) and a concomitant increase in CD3+DR+ activated T cells (P less than .001) and CD19+ B cells (P less than .05). These data indicate that CD4+ T-helper cells from patients with ATP are stimulated by normal platelet antigen(s) to secrete IL-2 and may modulate the enhanced antiplatelet autoantibody response.     

In vitro apoptosis and expression of apoptosis-related molecules in lymphocytes from patients with systemic lupus erythematosus and other autoimmune diseases

Objective. To analyze factors related to apoptosis in systemic lupus erythematosus (SLE) peripheral blood mononuclear cells (PBMC) and to compare the findings in SLE PBMC with those in normal donor PBMC or PBMC from patients with other autoimmune diseases. Methods. PBMC from normal healthy donors or patients with SLE, mixed connective tissue disease (MCTD), rheumatoid arthritis (RA), or various vasculitides were isolated. The percentage of apoptosis after activation through different signaling pathways was quantified using propidium iodide staining. Protein expression of Fas/APO-1 or bcl-2, and messenger RNA (mRNA) expression of bcl-2, bcl-x_L, bax, bak, Fas/APO-1, Fas ligand (Fas-L), c-myc, mad, or max were determined. Results. We confirmed previous findings of increased numbers of apoptotic cells in SLE PBMC compared with normal donor cells after in vitro incubation. After activation of PBMC with CD28 monoclonal antibody plus phorbol myristate acetate (CD28 MAb/PMA), staphylococcal enterotoxin B (SEB), or phytohemagglutinin (PHA), the percentage of apoptotic cells was unchanged (SEB) or diminished (CD28 MAb/PMA, PHA) in SLE cells, and the difference between normal donor and SLE cells was less pronounced. On the mRNA level, expression of apoptosis-related gene products did not differ between SLE cells and normal donor cells. Expression of Fas/APO-1 protein was increased in freshly isolated SLE T lymphocytes compared with normal donor T lymphocytes, whereas bcl-2 protein was up-regulated after a 3-day culture period. Cellular activation further increased bcl-2 protein levels, eliminating differences between normal donors and SLE patients. In RA cells, the percentage of apoptosis was similar to that in normal donor PBMC, whereas results using cells from patients with other autoimmune diseases (MCTD, Wegener's granulomatosis, Takayasu arteritis, polyarteritis nodosa) were comparable with those found using SLE PBMC. Addition of growth factors such as interleukin-2 (IL-2), IL-4, or IL-15 to culture medium decreased the percentage of in vitro apoptosis in both normal donor and SLE cells. Conclusion. Based on these data, we conclude that accelerated in vitro apoptosis and increased Fas/APO-1 and bcl-2 protein expression in SLE are nonspecific for the disease, and might be explained at least in part by the increased in vivo activation levels of PBMC from patients with SLE, MCTD, or autoimmune vasculitides combined with in vitro incubation under “noninflammatory” conditions and growth factor withdrawal.     

系统性红斑狼疮患者外周血单个核细胞T细胞受体重组删除环水平

目的 通过检测系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)T细胞受体重组删除环(TREC)水平,探讨其与临床表现间的关系及SLE的发病机制.方法 收集21例SLE组患者和22例年龄、性别相匹配的健康对照组一般临床资料;采集2组受试者外周静脉血,分离PBMC,实时荧光定量PCR检测TREC水平,结果以"TREC拷贝数/1000 PBMC"表示.结果 SLE组患者外周血PBMC中TREC水平为(9.6±7.5)拷贝/1000 PBMC,明显低于健康对照组[(16.1±11.1)拷贝/1000 PBMC,P=0.033].健康对照组PBMC中TREC水平与年龄呈负相关(r=-0.614,P=0.002),而SLE组无这种相关性.SLE组患者PBMC中TREC水平与SLEDAI评分呈负相关(r=-0.656,P=0.001),与皮肤黏膜受累旱负相关(r=-0.620,P=0.003),与其他临床表现及实验室指标无明显关联.结论 SLE患者外周血TREC水平降低提示SLE患者胸腺近期输出产物比例减少,这可能与该疾病造成胸腺近期输出功能减弱和(或)T细胞外周增殖增加有关.胸腺近期输出产物在外周T细胞池巾的含量减少,可能埘SLE患者免疫功能异常产生影响.     

Expression of costimulatory molecules on peripheral blood lymphocytes of patients with systemic lupus erythematosus

OBJECTIVE: In systemic lupus erythematosus (SLE) autoantibody production is T cell dependent. For a proper T and B cell interaction, signalling of costimulatory molecules on these cells is necessary. The expression of costimulatory molecules on peripheral blood lymphocytes in patients with SLE in conjunction with disease activity was measured to evaluate whether expression of costimulatory molecules in SLE is increased. METHODS: Thirteen patients with SLE with active disease, 10 patients with inactive disease, and 14 controls entered the study. In addition, samples from 10 of the 13 patients with active disease could be studied at a moment of inactive disease as well. Isolated peripheral blood lymphocytes were stained for the lymphocyte subset markers CD4, CD8, CD19, their respective activation markers CD25, HLA-DR, CD38, and the costimulatory molecules CD40L, CD28, CD40, CD80, and CD86. Expression was measured by flow cytometry. RESULTS: Peripheral blood lymphocytes of patients with SLE showed signs of increased activation at the moment of active disease. Almost all CD4+ T cells expressed CD28, both in patients and in controls. CD80 expression on CD19+ B cells was low in both groups and did not correlate with disease activity. In contrast, the percentage of CD19+ B cells expressing CD86 was increased in patients with SLE even in patients with inactive disease (p=0.04) and correlated with the SLEDAI score (p=0.0005) and levels of anti-dsDNA (p=0.006). No changes in CD40 or CD40L expression were found in the patients with SLE. CONCLUSION: In patients with SLE the expression of CD86 on CD19+ B cells is increased and is associated with disease activity, B cell activation, and levels of anti-dsDNA. The increased CD86 expression will render (autoreactive) B cells more susceptible for T cells. This can facilitate autoantibody production and might be a target for immunosuppressive treatments.     

Assessment of Be1 and Be2 cells in systemic lupus erythematosus indicates elevated interleukin-10 producing CD5+ B cells

Recent studies indicate that normal B cells can be primed to differentiate into two distinct cytokine-secreting effector subsets, Be1 and Be2. The aim of this study was to analyse, for the first time, Be1 and Be2 cells at the single cell level in SLE patients using the recently developed technique of flow cytometry for intracellular cytokines. Peripheral blood mononuclear cells (PBMC) from SLE patients and age- and sex-matched normal controls were cultured for 24 h in the presence or absence of phorbal myristate acetate and ionomycin (PMA/I) or lipopolysaccharide (LPS). The production of type I (IFN-gamma, IL-2) and type 2 (IL-4, IL-5, IL-6, IL-10, IL-13) cytokines by B cells (and IL-10 production by fractionated CD5+ and CD5- B cells) was investigated using an intracellular cytokine staining technique and flow cytometry. In the absence of PMA/I stimulation, the percentage of B cells from SLE patients was significantly lower than those of normal subjects and significantly more SLE B cells spontaneously produced IL-10 than controls. Moreover, CD5+ B cells from SLE patients were enriched for cells with signs of previous in vivo activation and for high levels of IL-10 production. A significant positive correlation was observed between the percentage of IL-10- and IL-6-producing PMA/I-stimulated B cells in SLE patients, but not in controls. There were no significant differences in the production of other cytokines by B cells of SLE patients and normal subjects. In conclusion, a general alteration of type 1 and type 2 cytokine production by B cells is not observed in SLE patients. The role of B cell cytokines in the pathogenesis of SLE appears to be exerted by elevated secretion of in vivo IL-10, which may play an important role in the immune dysregulation observed in SLE patients. Moreover, the cross regulation of IL-10 and IL-6 is disrupted in SLE patients.