类风湿关节炎外周血单核细胞亚群CD64表达及意义

目的：探讨CD64在类风湿关节炎（RA）患者外周血单核细胞亚群上的表达及临床意义，以阐明其在RA发生和发展中的作用。方法：应用流式细胞仪检测44例RA患者和22例正常对照者外周血单核细胞亚群的比例及其CD64的表达，比较RA组和正常对照组之间各单核细胞亚群的比例及其表面CD64表达水平，并分析各单核细胞亚群表面CD64表达与实验室检查数据的相关性。两组间比较采用t检验或者非参数检验，两变量之间相关性采用Pearson或Spearman相关分析。结果：(1)RA组中间型单核细胞比例高于对照组，差异有统计学意义(P<0.01)；RA组经典型单核细胞比例和非经典型单核细胞比例低于对照组(P<0.05)，差异有统计学意义。(2)RA组各单核细胞亚群CD64表达(MFI)显著高于对照组，差异有统计学意义(P<0.05)。(3)RA患者外周血经典型单核细胞和中间型单核细胞CD64表达(MFI)与DAS28呈正相关(r_s=0.308,P=0.044；r_s=0.302,P=0.049)。(4)RA患者各单核细胞亚群CD64表达(MFI)与ESR，CRP呈正相关(r_s=0.410,P=0.008；r_s=0.475,P=0.003；r_s=0.448,P=0.003；r_s=0.473,P=0.004；r_s=0.348,P=0.026；r_s=0.340,P=0.042)。(5)RA患者RF阳性组、ACPA阳性组外周血经典型单核细胞、中间型单核细胞上CD64表达(MFI)明显高于对应的阴性组，差异有统计学意义(P<0.05)。(6)中间型单核细胞CD64高表达组血清细胞因子IL-6水平明显升高，差异有统计学意义(P<0.05)。结论：RA患者外周血单核细胞亚群CD64表达异常，经典型单核细胞和中间型单核细胞CD64表达与炎症水平、自身抗体产生和疾病活动性有明确的相关性。以外，中间型单核细胞CD64的表达与细胞因子相关。

Expression and significance of CD64 on monocyte subsets from patients with rheumatoid arthritis

Objective:To investigate the expression of CD64 on monocyte subset from patients with rheumatoid arthritis (RA)and its significance and to clarify its role in the development of RA. Methods: The peripheral blood from 44 patients and 22 healthy controls (HC)were collected,the proportions of each monocyte subset and the CD64 expression on monocyte subsets were detected by flow cytometry.The proportions of each monocyte subset and the expression of TIGIT on monocyte subsets were compared between RA patients and HC.The correlations of CD64 expression on monocyte subsets with laboratory index were analyzed.The data were statistically analyzed.Results: (1)The proportion of intermediate monocytes in patients with RA was significantly higher than that in healthy volunteers (P<0.01),while the proportion of classical and nonclassical monocytes in patients with RA was significantly lower than that in healthy volunteers (P<0.05).(2)The expression of CD64 (MFI)on monocyte subsets were significantly elevated in RA patients compared to healthy volunteers (P<0.05).(3)The expression of CD64 on classical monocytes and intermediate monocytes were positively correlated with DAS28 score (r_s=0.308,P=0.044；r_s=0.302,P=0.049).(4)The expression of CD64 (MFI)on monocyte subsets were positively correlated with ESR and CRP (r_s=0.410,P=0.008；r_s=0.475,P=0.003；r_s=0.448,P=0.003；r_s=0.473,P=0.004；r_s=0.348,P=0.026；r_s=0.340,P=0.042).(5)The expression of CD64 on classical monocytes and intermediate monocytes were significantly increased in patients with positive RF and ACPA respectively(P<0.05).(6)The RA patients with high levels of CD64 on intermediate monocytes exhibited significantly higher levels of IL-6 compared with the RA patients with low levels of CD64 on intermediate monocytes (P<0.05).Conclusion: In RA,the expression of CD64 on monocyte subsets are elevated,and the expression of CD64 on classical monocytes and intermediate monocytes associated with the inflammatory markers,the production of antibodies and the disease activity.In addition,the expression of CD64 on intermediate monocytes associated with cytokine.