类风湿关节炎患者外周血Treg细胞及其分泌IL-35水平检测与临床意义

目的 探讨类风湿关节炎(RA)患者外周血中调节性T细胞(Treg)的数量,以及其所分泌的白细胞介素(IL)-35表达水平与RA发病的相关性.方法 采集45例RA患者(RA组),22例骨关节炎(OA)患者(OA组),26例健康体检者(对照组)的外周血,流式细胞术检测CD4+ CD25+ foxp3+ Treg数量,ELISA检测血浆IL-35水平.分析Treg细胞及其表达的IL-35与临床指标间的相关性.结果 RA组外周血中Treg细胞占CD4+T细胞的百分率(5.65±2.33)％]较对照组(4.12±1.75)％]明显升高(P＜0.05);OA组与RA组比较,差异无统计学意义(P=0.086).3组对象foxp3平均荧光强度比较,差异无统计学意义(P＞0.05);DAS28评分越高的患者,其外周血Treg细胞数量和foxp3荧光强度越低.RA组血浆IL-35(34.22±14.35)ng/L]水平明显低于OA组(78.63±24.58)ng/L]和对照组(67.56±25.43)ng/L],差异均有统计学意义(P＜0.05).RA患者Treg细胞数量与红细胞沉降率(ERS)、DAS28评分呈负相关(r=-0.223、-0.343,P=0.023、0.011),而与类风湿因子、C反应蛋白、抗CCP抗体无相关性.结论 RA患者外周血中Treg细胞数量增高,IL-35水平降低;Treg细胞功能缺陷致负调控能力减弱.

Detection of peripheral blood Treg cells and secreted IL-35 level in patients with rheumatoid arthritis and its clinical significance

Objective To detect the number of peripheral blood Treg cells and secreted IL-35 expression level in the patients with rheumatoid arthritis(RA) and to explore their correlation with RA occurrence.Methods Peripheral blood was collected from 45 cases of RA,22 cases of osteoarthritis(OA) and 26 persons undergoing healthy physical examination(control group).The number of CD4+ CD25+ foxp3+ regulatory T cells was determined by flow cytometry,while plasma IL-35 level was determined by ELISA.Then the relationship between Treg and expressed IL-35 with clinical indicators was analyzed.Results The percentage of peripheral blood Treg ceils to total CD4+T cells in the RA group was (5.65 ± 2.33)％,which was significantly increased compared with (4.12 ± 1.75) ％ in the control group(P＜0.05);the difference between the OA group and RA group was not statistically significant(P=0.086).The average fluorescence intensity of foxp3 had no statistical difference among 3 groups(P＞0.05).The higher the DAS28 score,the lower the peripheral blood Treg cells number and foxp3 fluorescence intensity.The plasma IL-35 level in the RA group (34.22± 14.35)ng/L] was significantly lower than that in the OA group(78.63± 24.58)ng/L] and control group (67.56±25.43)ng/L],the difference was statistically significant(P＜0.05).The Treg number in RA patients was negatively correlated with ESR and DAS28 score(r=-0.223,-0.343,P=0.023,0.011),but had no correlation with rheumatoid factor,C-reactive protein and anti-CCP antibody.Conclusion The peripheral blood Treg cells number in RA patients is elevated,while the IL-35 level is decreased,the negative regulation ability in the patients with Treg cell function deficit is attenuated.