炎症性肠病患者CD27-CD70共刺激途径的激活研究

目的 探讨CD27-CD70共刺激途径在炎症性肠病患者外周循环和肠黏膜中的表达,比较炎症性肠病患者CD27-CD70表达与正常对照者间的差异.方法 共纳入62例克罗恩病(CD)、64例溃疡性结肠炎(UC)患者和56名正常对照者.应用酶联免疫吸附试验分析炎症性肠病患者和正常对照者血浆中CD27-CD70蛋白的表达;SYBR-green实时PCR法分析炎症性肠病患者和正常对照者外周血单个核细胞中CD27-CD70 mRNA的表达;免疫组化法分析炎症性肠病患者和正常对照者肠黏膜组织CD27-CD70蛋白的表达.结果 CD和UC患者血浆中CD27-CD70的表达均显著高于正常对照者(P值均<0.05).ROC曲线的分析表明,CD27-CD70对区分CD患者和正常对照者以及区分UC患者和正常对照者具有显著的诊断价值(P值均<0.05).CD患者血浆中CD27和CD70水平与内镜下疾病活动性(EDAI)无关(r值分别=0.055和0.024,P值分别为0.673和0.852),且UC患者血浆中CD27和CD70水平与EDAI无关(r值分别=0.077和0.021,P值分别为0.547和0.869).CD患者和UC患者外周血单个核细胞CD27和CD70 mRNA表达均显著高于正常对照者外周血单个核细胞中mRNA的表达(P值均=0.000).免疫组化实验表明CD患者和UC患者肠黏膜组织CD27和CD70的表达均显著高于正常对照者(P值均=0.000).结论 炎症性肠病患者血浆、外周血单个核细胞和肠黏膜中均存在CD27-CD70途径的激活,但血浆中CD27-CD70的水平不能反映内镜下疾病活动程度.选择性干预CD27-CD70共刺激通路可能成为缓解或减轻炎症性肠病进程的有益尝试.

Study on activation of CD27-CD70 co-stimulatory pathway in patients with inflammatory bowel disease

Objective To investigate the expression of CD27-CD70 co-stimulatory pathway in peripheral circulation and intestinal mucosa of patients with inflammatory bowel disease, and to find the difference between the expression of CD27-CD70 in patients with inflammatory bowel disease and in healthy controls. Methods A total of 62 patients with Crohn's disease, 64 patients with ulcerative colitis and 56 healthy controls were enrolled. Enzyme-linked immunosorbent assay was applied to evaluate plasma CD27-CD70 protein expression in patients with inflammatory bowel disease and healthy controls. SYBR-green real time PCR was applied to access CD27-CD70 mRNA expression in peripheral blood mononuclear cells in patients with inflammatory bowel disease and healthy controls.And CD27-CD70 protein expression in intestinal mucosa was determined by immunohitochemistry.Results Plasma levels of CD27 (P=0. 025) and CD70 (P=0. 000) were significantly higher in patients with Crohn's disease than in healthy controls. However, CD27 (r= 0. 055, P= 0. 673) and CD70 (r= 0. 024, P = 0. 852) were not significantly associated with endoscopic disease activity in patients with Crohn's disease. Similarly, CD27 (P=0. 001) and CD70 (P=0. 000) were significantly higher in patients with ulcerative colitis than in healthy controls. And CD27 (r=0. 077, P=0. 547)and CDT0 (r=0.021, P=0. 869) were not significantly associated with endoscopic disease activity in patients with ulcerative colitis. Moreover, CD27 and CD70 mRNA expression in peripheral blood mononuclear cells were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000), and immunostaining indicated that CD27 and CD70 expression in intestinal mucosa were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000). Conclusions CD27-CD70 pathway activated in plasma, peripheral blood mononuclear cells and intestinal mucosa of patients with inflammatory bowel disease. However,plasma levels of CD27 and CD70 can not reflect endoscopic disease activity.