系统性红斑狼疮患者外周血淋巴细胞穿孔素表达及糖皮质激素对穿孔素的影响

目的 研究系统性红斑狼疮(SLE)患者外周血淋巴细胞穿孔素(PF)表达与分布,PF水平与疾病活动的相关性,探讨PF在SLE发病机制中的作用,观察糖皮质激素治疗对PF表达的影响.方法 SLE活动期患者16例,健康对照者12名.用流式细胞仪检测外周血淋巴细胞PF、CD3、CD4或CD8表达,用直线相关分析PF水平与SLE疾病活动性评分(SLEDAI)的相关性;比较糖皮质激素治疗前后PF水平变化.结果 与健康对照组比较,SLE活动期患者组外周血PF+淋巴细胞的百分率显著增高(P<0.01),PF的平均荧光强度(PFMFI)增高(P<0.01),PF+CD8+CD3+淋巴细胞的百分率明显增加(P<0.01),差异均有统计学意义.SLE活动期患者外周血PP淋巴细胞百分率与SLEDAI呈正相关(r=0.673).经过短期大剂量糖皮质激素治疗,SLE活动期患者外周血淋巴细胞PF+细胞百分率和PFMFI都显著下降(P<0.05),差异有统计学意义.结论 SLE活动期患者PF高表达,主要分布于CD8+CD3+细胞;PF水平与SLE活动程度呈正相关;短期糖皮质激素治疗能够减少患者体内PF表达.

Perforin expression on peripheral lymphocytes of patients with systemic lupus erythematosus and the effect of glucocorticosteroid on its expression

Objective To investigate the quantity of perforin (PF) expressed on peripheral lymphocytes of active systemic lupus erythematosus (SLE) patients and its distribution in lymphocytes subsets. The effect of glucocorticosteroid on PF expression is also explored. Methods Phenotype analysis of peripheral lymphocytes was carried out by flow cytometry. SLE patients with SLEDAI≥10 (n=16) and normal controls (n=12) were enrolled into this study. The PF expressed on the iymphocytes of SLE patients with disease flares (n=10) Was studied before and after glucocorticosteroid treatment. Results SLE patients with active disease were characterized by higher proportions of PF-positive lymphocytes and higher perforin density. PF and CD8 double positive T cell proportions was evidently increased. The proportions of PF-positive lymphocytes was correlated to SLEDAI (r=0.673). After a short period of glucocorticosteroid therapy, a reduced expression of PF was observed. Conclusion There is an increased expression of perforin in peripheral lymphocytes from SLE patients with active disease. CD8 positive T cell subsets expand significantly in those patients. In addition, the frequency of PF-positive lymphocytes is correlated with SLEDAI. Finally, glucocorticosteroid inhibits the expression of perforin.