免疫治疗对重症肌无力病人淋巴细胞亚型的影响

目的 研究重症肌无力（ＭＧ）患者细胞免疫的异常改变和糖皮质激素及胸腺切除对各淋巴细胞亚群的影响。方法 采用免疫荧光双标记技术和流式细胞仪对３９例ＭＧ患者和１８例健康对照者周围血中淋巴细胞表型分析,并对１５例ＭＧ患者经患者经糖皮质激素治疗前后和７例ＭＧ患者在胸腺切除前后淋巴细胞亚群的百分率的变化进行观察。结果（１）ＭＧ患者总Ｔ细胞,总Ｂ细胞（ＣＤ１９＾＋）,传统Ｂ细胞（ＣＤ５＾－ＣＤ１９＾＋）,ＣＤ

Effect of immunologic treatment on lymphocyte subsets in patients with myasthenia gravis

OBJECTIVE: To study the abnormalities of cellular immunity of myasthenia gravis (MG) and the effects of glucocorticoid (GC) therapy and thymectomy on lymphocyte subsets in patients with myasthenia gravis. METHODS: Phenotypic analysis of peripheral blood lymphocyte in 39 patients with MG and 18 healthy controls were completed using flow cytometry and immunofluorescence double-staining methods; changes of lymphocyte subsets were studied in 15 of the MG patients after GC therapy and 7 of the MG patients after thymectomy. RESULTS: (1) The percentage of pan-T (CD(+)(5)), pan-B (CD(+)(19)), traditional B cell, CD(+)(4)T cell in patients with MG did not significantly differ from that in healthy controls. An increase in CD(+)(8) cell was observed in MG patients as compared with normal controls. Among the CD(+)(4) T lymphocyte subsets, there was significant decrease of the percentage of CD(+)(4) CD(45)RA(+) (suppressor-inducer) and increase of the percentage of CD(+)(4) CD(45)RA(-) (helper-inducer) subsets in MG patients than controls; the percentage of CD(+)(5) B cell was significantly increased in MG patients as compared with that in healthy controls. (2) After GC therapy, the percentages of pan-T (CD(+)(5)), pan-B (CD(+)(19)), traditional B cell, CD(+)(4) T cell, CD(+)(8) T cell, CD(+)(4) CD(45)RA(-), CD(+)(5) B cell decreased. (3) After thymectomy, the proportions of T, B lymphocyte subsets did not change significantly. CONCLUSION: Not only changes of T cell subsets (CD(+)(4) and CD(+)(8) T lymphocyte subsets) were shown, but also there were abnormal changes of functional CD(+)(4) T lymphocyte subsets and CD(+)(5) B lymphocyte which may play an important role in the pathogenesis of MG. There is comprehensive inhibiting action of GC on cellular immunity in MG patients, while there is no such effect with thymectomy on the lymphocyte subsets in MG patients.