MS患者泼尼松治疗前后外周血Th1、Th2、Th17、Treg、Tc1和Tc2淋巴细胞亚群变化

目的 探讨多发性硬化(MS)患者泼尼松治疗前后外周血Tc1、Tc2、Treg、Th1、Th2及Th17淋巴细胞亚群变化。方法 选取本院45例MS患者(病例组)和35例同期于本院行常规体检的健康人员(对照组),比较病例组治疗前与对照组体检之日T淋巴细胞亚群和血浆细胞因子的水平,并比较病例组治疗前和泼尼松治疗后T淋巴细胞亚群和血浆细胞因子的水平。结果 病例组Tc1,Treg细胞百分率较对照组均明显降低,Th1,Th17细胞百分率较对照组显著增高,Th17/Treg细胞比例较对照组显著增高(P<0.01); 病例组与对照组Tc2,Th2细胞百分率及Th1/Th2细胞比例的比较均无明显差异(P>0.05); 与治疗前比较,病例组治疗1个月后Th1,Th17细胞百分率均明显降低,Treg,Tc1,Tc2细胞百分率均显著增高,Th17/Terg细胞比例显著下降(P<0.01); 病例组治疗1个月后Th2、Th1/Th2细胞比例与治疗前比较均无明显差异(P>0.05)。病例组白细胞介素-4(IL-4)和白细胞介素-10(IL-10)水平较对照组均显著下降,白细胞介素-17A(IL-17A)和 SymbolgA@ -干扰素水平较对照组均明显增高(P<0.01); 与治疗前比较,病例组治疗1个月后IL-4和IL-10水平均明显增高,IL-17A和 SymbolgA@ -干扰素水平显著下降(P<0.01)。结论 MS的发生可能与Treg下调、Th17上调密切相关,推测可能通过MS靶向提高Treg与降低Th17细胞百分率来维持Th17/Treg细胞比例的平衡。

The changes of Th1, Th2, Th17, Treg,Tc1 and Tc2 lymphocyte subsets in peripheral blood of MS patients before and after prednisone treatment

ObjectiveTo study the changes of peripheral blood Tc1, Tc2, Treg, Th1, Th2 and Th17 lymphocyte subsets in patients with multiple sclerosis(MS)before and after prednisone treatment.Methods 45 MS patients(case group)and 35 healthy persons(control group)who underwent routine physical examination in our hospital at the same time were selected. The levels of T lymphocyte subsets and plasma cytokines were compared between the case group before treatment and the control group on the day of physical examination, and the levels of T lymphocyte subsets and plasma cytokines before treatment and after prednisone treatment were compared in the case group.Results The percentage of Tc1 and Treg cells in the case group was significantly lower than that in the control group, the percentage of Th1 and Th17 cells was significantly higher than that in the control group, and the percentage of Th17/Treg cells was significantly higher than that in the control group(P<0.01). There was no significant difference in the percentage of Tc2 cells, Th2 cells and Th1/Th2 cells between the case group and the control group(P>0.05). Compared with before treatment, the percentage of Th1 and Th17 cells in the case group decreased significantly after treatment, the percentage of Treg, Tc1 and Tc2 cells increased significantly, and the percentage of Th17/Terg cells decreased significantly(P<0.01). The percentage of Th2 and Th1/Th2 cells in the case group had no significant difference after treatment compared with that before treatment(P>0.05). The levels of interleukin-4(IL-4)and interleukin-10(IL-10)in the case group were significantly lower than those in the control group, and the levels of interleukin-17A(IL-17A)and interferon- SymbolgA@ were significantly higher than those in the control group(P<0.01). Compared with before treatment, the levels of IL-4 and IL-10 in the case group increased significantly after treatment, while the levels of IL-17A and IFN- SymbolgA@ decreased significantly(P<0.01).Conclusion The occurrence of MS might be closely related to Treg down-regulation and Th17 up-regulation. It was speculated that the proportion of Th17/Treg cells could be maintained by MS targeting to increase Treg and decrease Th17 cells in clinic.