SARS患者康复期T细胞亚群、活化状态及TCR Vβ表达格局的分析

目的：研究中西医结合治疗后，SARS患者康复期淋巴细胞功能状态和T细胞受体(TCR)Vβ24个亚家族表达的格局。方法：应用流式细胞分析技术，观察我院76例康复期患者T细胞亚群，T、B细胞的活化状态及CD3^ 和TCR Vβ1、2、3、4、5．1、5．2、5．3、7．1、7．2、8、9、11、12、13．1、13．2、13．6、14、16、17、18、20、21．3、22及23等24个亚家族的表达。结果：T细胞亚群中，CD3^ 和CD4^ T细胞的百分率均数低于参考值；CD8^ T细胞的百分率高于参考值。CD8^ ／CD28^-T细胞(Ts)的百分率较参考值增高；而CD8^ ／CD28^ T细胞(Tc)的百分率较参考值降低，其中有39例Tc细胞的百分率降低，有48例Ts细胞的百分率升高。CD3^ HLA-DR^ 和CD3^-／HLA-DR^ 细胞的百分率高于正常参考值，增加的例数分别是36例和30例。TCR Vβ24个亚家族中，TCR Vβ14的表达最高，TCR Vβ5．3和23的表达次之，表现出TCR Vβ呈优势表达。正常对照组TCR Vβ24个亚家族中，只TCR Vβ14的表达最高，与SARS患者的结果相一致；但TCR Vβ24个亚家族的分布格局不一样。两组比较，Vβ1、Vβ5．2、Vβ5．3、Vβ7．2、Vβ9、Vβ11、Vβ13．1、Vβ13．2、Vβ17、Vβ18、Vβ22和Vβ23表达有显著性差异，康复期SARS患者组均高于正常对照组。同时，SARS患者激素用量大于1000U组，TCR Vβ4、22和23的表达均高于未用激素组。结论：康复期患者CD8^ ／CD28^-T细胞数的升高可导致CD8^ T细胞数升高；Ts细胞数的增加，因其分泌的抑制因子增多，从而造成CD3^ 和CD4^ T细胞数降低。SARS患者康复期TCRVB24个亚家族在T细胞上的表达不同：CD3^ ／HLA-DR^ 和CD3^ ／HLA-DR^ T细胞数的升高，可能与T、B细胞的活化较晚有关。

Analyses of subset, activated state and expression pattern of 24 repertoire TCR Vβ of peripheral blood T lymphocytes in convalescence patients with severe acute respiratory syndrome(SARS)

AIM: To study the function of lymphocytes and the expression pattern of 24 repertoire TCR Vbeta in the convalescent patients with severe acute respiratory syndrome(SARS) after treatment by combination of traditional Chinese and Western medicine. METHODS: T lymphocyte subsets, activated states of T and B lymphocytes, and expressions of CD3(+) and 24 TCR Vbeta subfamilies in 76 convalescent SARS patients were detected by flow cytometry. RESULTS: The percentages of CD3(+) and CD4(+) T cells were lower than normal reference (P<0.05 and P<0.01, respectively). The percentage of CD8(+) T lymphocytes was higher than normal reference (P<0.01),while the percentage of CD8(+)/CD28(-) T cells (Ts) in 49 convalescent SARS patients increased, and that of CD8(+)/CD28(+) T cells (Tc) in 39 patients decreased. The percentage of activated T cells (Ta,CD3(+)/HLA-DR(+)) in 36 convalescent SARS patients and the percentage of activated B cells (Ba, CD3(-)/HLA-DR(+)) in 30 convalescent SARS patients were higher than normal references. Expression of TCR Vbeta14 was the commonest in 24 TCR Vbeta repertoire both in SARS patients and normal controls, followed by TCR Vbeta5.3 in SARS patients, but Vbeta20 in normal controls. Besides, the expressions of TCR Vbeta1, Vbeta5.2, Vbeta5.3, Vbeta7.2, Vbeta9, Vbeta11, Vbeta13.1, Vbeta13.2, Vbeta17, Vbeta18, Vbeta22 and Vbeta23 in SARS group were all significantly higher than those in normal group. And the expressions of TCR Vbeta4, Vbeta22 and Vbeta23 in SARS patients treated with glucocorticoid(>1 000 U) were higher than those in SARS patients without treatment. CONCLUSION: Increased Ts cell may lead to increased CD8(+) T cells in convalescent SARS patients. The suppressor factors secreted by Ts cells may decrease CD3(+) and CD4(+) T cells. Expression of TCR Vbeta on T cells from convalescent SARS patients were different from normal controls. The increased Ta and Ba expressions may be associated with activation of T and B cells.