调节性及辅助性T细胞在人类IgA肾病中的表达及意义

目的 探讨CD4+CD25high调节性T细胞（Treg）及辅助性T细胞亚群（Th1、Th2）比例失衡在IgA肾病（IgAN）免疫发病机制中的作用。 方法 用流式细胞仪检测IgAN患者外周血Treg及Th1、Th2的比例。以胞内染色技术检测叉头框蛋白3（FOXP3）的表达。Treg及Th1、Th2的比例与IgAN各项临床病理指标的相关性分析采用Spearman或Pearson相关分析法。 结果 IgAN患者外周血中Treg比例明显高于健康人（2.14±0.82）％比（1.59±0.53）％，P ＜ 0.05]，与血IgA水平呈正相关（r = 0.397，P ＜ 0.05），与eGFR呈负相关（r = -0.376，P ＜ 0.05）。IgAN患者外周血中Th2细胞比例显著高于健康对照组（2.57±0.72）％比（1.81±1.10）％，P ＜ 0.05]，与血IgA水平呈正相关（r = 0.468，P ＜ 0.05）。IgAN患者Th1/Th2比值显著低于健康对照组（5.75±1.89比12.73±9.79，P ＜ 0.05），但与临床各指标间没有相关性。 结论 IgAN患者体内存在T细胞亚群表达紊乱。Treg在外周血中的增多以及以Th2为优势的Th1/Th2失衡可能在IgAN的发病中起重要作用。

Expression of regulatory T cells and helper T cells in human IgA nephropathy and its significance

Objective To investigate the effects of CD4+CD25high regulatory T cells(Treg)and the imbalance of helper T lymphocyte subsets(Th1/Th2)on the immunological mechanism of IgA nephropathy(IgAN)patients. Methods The percentage of Treg and helper T cells subpopulation (Th1/Th2)in the peripheral blood of IgAN patients and healthy controls was examined by flow cytometry.The FOXP3 expression was detected through intracellular staining.The correlation of Treg or Th1/Th2 with clinical parameters of IgAN was analyzed by Spearman or Pearson rank correlation test. Results The percentages of Treg and Th2 cells were significantly higher in peripheral blood of IgAN patients compared to that of healthy controlsTreg (2.14±0.82)%vs1.59±0.53)%,Th2(2.57±0.72)%vs(1.81±1.10)%,all P＜0.05].Th1/Th2 ratio was significantly reduced in IgAN patients(5.75±1.89 vs 12.73±9.79,P＜0.05).The percentage of circulating Treg cells was positively correlated with serunl IgA concentration(r=0.397,P＜0.05),and was negatively correlated with eGFR(r=-0.376,P＜0.05).The percentage of circulating Th2 cells was positively correlated with serum IgA(r=0.468,P＜0.05). Conclusions There is a disorder of T lymphocyte population in the peripheral blood of IgAN patients.The increased Treg and Th2 cells may play an important role in the pathogenesis of IgAN.