帕金森病患者外周血中骨髓来源抑制性细胞的检测及临床意义

目的:检测帕金森病患者外周血中2群骨髓来源抑制性细胞及相关临床意义。方法:选择2016年1月~2017年3月于我院收治并确诊为帕金森病的患者80人和健康志愿者20人为研究对象。按照HoehnYahr分期法将80名患者进行分期,其中Ⅰ级22人,Ⅱ级24人,Ⅲ级20人, Ⅳ级14人,Ⅴ级0人。分别收集帕金森病患者和健康志愿者的外周血各5 mL,分离获得单个核细胞,采用流式细胞术检测外周血中CD14~+CD11b~+和CD14~-CD11b~+细胞的水平,磁珠分选2群细胞,通过q PCR检测2群细胞中免疫抑制相关因子精氨酸酶1(ARG1)、白细胞介素10(IL~-10)和环氧合酶2(COX-2)的mRNA水平,Western blot法和ELISA法检测2群细胞表面膜蛋白CD14和CD11b,以及ARG1、IL~-10和COX~-2蛋白表达水平。结果:帕金森病患者外周血中CD14~+CD11b~+细胞比例与正常人相比无明显变化,而CD14~-CD11b~+细胞比例显著增加(P0.05);不同分期的帕金森病患者外周血中CD14~-CD11b~+细胞比例与Hoehn~-Yahr分期呈正相关,且CD14~-CD11b~+和CD14~+CD11b~+细胞共同高表达IL~-10和COX~-2,仅CD14~-CD11b~+细胞中高表达ARG1,与CD14~+CD11b~+细胞和正常人的2群细胞比较具有显著差异(P0.05)。结论:帕金森病患者外周血中CD14~-CD11b~+细胞和ARG1的高水平表达可以作为帕金森病发病和分期的参考依据。免疫抑制在帕金森病的发生和发展中具有重要的意义。

Detection and clinical significance of myeloid-derived suppressor cells in peripheral blood of patients with Parkinson disease

AIM: To detect the myeloid-derived suppressor cells (MDSCs) in peripheral blood from the patients with Parkinson disease (PD) and its clinical significance. METHODS: The patients (n=80) diagnosed PD from January 2016 to March 2017 in our hospital and 20 healthy volunteers were selected as the subjects. According to the Hoehn-Yahr staging, 80 PD patients were staged, of whom 22 were I, 24 were Ⅱ, 20 were Ⅲ, 14 were IV, and 0 was V. Peripheral blood (5 mL) samples from the patients with PD and the healthy volunteers were collected and the mononuclear cells were isolated. The levels of CD14⁺CD11b⁺ cells and CD14^-CD11b⁺ cells in the peripheral blood were detected by flow cytometry. The two populations of the cells were sorted by magnetic beads. The mRNA levels of arginase 1 (ARG1), interleukin-10 (IL-10) and cyclooxygenase 2 (COX-2) were detected by qPCR. The expression of surface membrane proteins CD14 and CD11b, and immunosuppressive factors ARG1, IL-10 and COX-2 was determined by Western blot and ELISA. RESULTS: No significant change of CD14⁺CD11b⁺ cells between the patients with PD and normal controls was observed, but the cells with CD14^-CD11b⁺ increased significantly in the patients with PD compared with the control people (P<0.05). The CD14^-CD11b⁺ cells in peripheral blood of the patients were related to the stage of Hoehn-Yahr. The CD14^-CD11b⁺ and CD14⁺CD11b⁺ cells showed high levels of IL-10 and COX-2, and the high level of ARG1 was only expressed in the CD14^-CD11b⁺ cells. The expression of ARG1 in the CD14^-CD11b⁺ population from PD patients was significantly different from that of CD14⁺CD11b⁺ population and normal subjects (P<0.05). CONCLUSION: The CD14^-CD11b⁺ cells and ARG1 expression level in peripheral blood of the PD patients can be used to evaluate the pathogenesis and staging. Immunosuppression may play an important role in the pathogenesis and development of PD.