腰椎间盘退变性疾病与外周血淋巴细胞亚群的关系

文题释义：淋巴细胞亚群：淋巴细胞是白细胞的一种，是机体免疫应答功能的重要细胞成分，是淋巴系统几乎全部免疫功能的主要执行者，占外周血白细胞总数的20%-40%，按其发生迁移、表面分子和功能的不同，主要分成T淋巴细胞、B淋巴细胞和自然杀伤细胞三大类。 自然杀伤细胞(natural killer cell，NK)：是机体重要的免疫细胞，不仅与抗肿瘤、抗病毒感染和免疫调节有关，而且在某些情况下参与超敏反应和自身免疫性疾病的发生。 背景：既往研究认为椎间盘退变的主要原因为遗传、衰老、营养不良和负荷史，免疫系统在椎间盘退变过程中的作用尚不清楚。 目的：观察腰椎间盘退变患者外周血淋巴细胞亚群的变化，并研究腰椎间盘退变程度与外周血各淋巴细胞亚群的关系。 方法：收集76例腰椎间盘退变性疾病患者和56例健康志愿者(对照组)的血样，用流式细胞仪检测外周血各淋巴细胞亚群，包括CD3⁺T细胞、CD4⁺T细胞、CD8⁺T细胞、CD19⁺B细胞、CD3^-CD16⁺CD56⁺自然杀伤细胞等淋巴细胞亚群的百分率，计算CD4⁺/CD8⁺比值。采用Pfirrmann分级标准评估2组腰椎间盘退变程度和分级，进一步评估外周血各淋巴细胞亚群与腰椎间盘退变程度的相关性。研究经郑州大学第一附属医院伦理审查委员会批准(伦理批号：2019-KY-285)，所有受试者都签署了知情同意书。 结果与结论：①腰椎间盘退变性疾病组的腰椎间盘退变程度明显高于对照组(P < 0.05)；②腰椎间盘退变性疾病组CD4⁺T细胞百分率、自然杀伤细胞百分率和CD4⁺/CD8⁺比值明显高于对照组(P < 0.05)；腰椎间盘退变性疾病组CD8⁺T细胞百分率较对照组显著降低(P < 0.05)；③对照组腰椎间盘退变程度与外周血各淋巴细胞亚群无相关性；腰椎间盘退变性疾病组腰椎间盘退变程度与CD4⁺ T细胞百分率、CD4⁺/CD8⁺比值、自然杀伤细胞百分率成线性正相关(r =0.412，P=0.000；r=0.715，P=0.000；r=0.494，P=0.000)，与CD8⁺ T细胞百分率成线性负相关(r=-0.737，P=0.000)；④结果表明，腰椎间盘发生退行性改变可能与外周血各淋巴细胞亚群改变有关，且CD4⁺T细胞增多、自然杀伤细胞增多以及CD4⁺/CD8⁺比值增高可能加速腰椎间盘退变。提示，免疫系统改变预示腰椎间盘退变发生的可能，其有望成为腰椎间盘退变性疾病的防治靶点。 ORCID: 0000-0002-8087-2356(冯阳) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Relationship between degenerative lumbar disc disease and peripheral blood lymphocyte subsets

BACKGROUND:Previous studies have suggested that the main causes of disc degeneration are heredity,aging,malnutrition and load history.The role of immune system in the process of intervertebral disc degeneration is not clear.OBJECTIVE:To observe the changes of peripheral blood lymphocyte subsets in patients with lumbar disc degeneration,and to study the relationship between the severity of lumbar disc degeneration and peripheral blood lymphocyte subsets.METHODS:Blood samples were collected from 76 patients with degenerative lumbar disc disease(experimental group)and 56 healthy volunteers(control group).The percentages of peripheral blood lymphocyte subsets including CD3+T cells,CD4+T cells,CD8+T cells,CD19+B cells,and CD3-CD16+CD56+natural killer(NK)cells were measured by flow cytometry.The ratio of CD4+/CD8+was calculated.The Pfirrmann grading standard was used to evaluate the grade of lumbar disc degeneration in the two groups,and the correlation between peripheral blood lymphocyte subsets and lumbar disc degeneration was further evaluated.The study protocol was approved by the Ethic Committee of the First Affiliated Hospital of Zhengzhou University in China with approval No.2019-KY-285.Each participant signed informed consent prior to the study.RESULTS AND CONCLUSION:The degenerative grade of the experimental group was significantly higher than that in the control group(P<0.05).The percentages of CD4+T cells,NK cells and the ratio of CD4+/CD8+in the experimental group were significantly higher than those in the control group(P<0.05).The percentage of CD8+T cells in the experimental group was significantly lower than that in the control group(P<0.05).There was no correlation between the grade of lumbar disc degeneration and lymphocyte subsets of the peripheral blood in the control group.In the experimental group,there was a linear positive correlation between the grade of lumbar disc degeneration and the percentage of CD4+T cells,the ratio of CD4+/CD8+,and the percentage of NK cells(r=0.412,P=0.000;r=0.715,P=0.000;r=0.494,P=0.000),and there was a linear negative correlation between the grade of lumbar disc degeneration and the percentage of CD8+T cells(r=-0.737,P=0.000).Our results suggest that degenerative changes of the lumbar disc may be related to the changes of lymphocyte subsets in peripheral blood,and the increase of CD4+T cells,NK cells and CD4+/CD8+ratio may accelerate lumbar disc degeneration.Therefore,changes in the immune system may predict the occurrence of lumbar disc degeneration and may be a target for prevention and treatment of degenerative lumbar disc diseases.