类风湿性关节炎患者外周血NKG2D、NKG2A及颗粒酶B表达的研究

目的 本研究旨在探讨类风湿性关节炎（rheumatoid arthritis，RA）患者外周血中NK细胞表达NKG2D、NKG2A及胞内颗粒酶B的水平，并且分析它们与疾病活动度（DAS28）的相关性。方法 流式细胞术检测41例RA患者和35例健康对照者外周血中NK细胞、NKG2D⁺NK细胞、NKG2A⁺NK细胞以及颗粒酶B⁺NK的表达水平；采用Spearman秩相关分析法分析它们与DAS28的相关性。结果 RA患者外周血中，NK细胞表达水平显著低于健康对照组（P=0.016）；NKG2D的表达水平显著低于健康对照组（P=0.002），且NKG2D的表达水平与DAS28评分呈负相关（P<0.05）；NKG2A的表达水平与健康对照组之间比较差异无统计学意义（P=0.547），且与DAS28评分不存在显著相关性（P>0.05）；颗粒酶B的表达水平有所降低（P=0.034），但与DAS28评分不存在显著相关性（P>0.05）。结论 活化性受体NKG2D以及胞内颗粒酶B表达的异常降低可能导致NK细胞杀伤活性的损伤，不能有效杀伤免疫效应细胞，从而促进了RA的发生、发展。

Investigation on the Peripheral Blood Expressing NKG2D,NKG2A,Granzyme B of Patients with Rheumatoid Arthritis

Objective To investigate the expression of NKG2D,NKG2A, intracellular granzyme B in NK cells from patients with rheumatoid arthritis (RA) and their associations with the disease activity. Methods We studied 41 RA patients as well as 35 healthy controls. NK,NKG2D,NKG2A,granzyme B expression were analyzed by flow cytometry in peripheral blood mononuclear cells (PBMC). Results We found that NK cells from RA patients as well as NKG2D and granzyme B showed a diminished expression compared with healthy controls(P<0.05); but NKG2A had no significant difference between RA and healthy controls(P=0.547). Spearman analysis showed that the levels of NKG2D was negatively associated with DAS 28 score(P<0.05), but no significant correlation were detected between the levels of NKG2A and DAS 28 score as well as granzyme B (P>0.05). Conclusion The lower expression of activating receptor NKG2D and intracellular granzyme B may lead to the killing activity damage of NK cells, can not effectively killing immune effector cells, thus contributing to the development of RA.