类风湿关节炎患者Th1Th2细胞平衡的研究.docVIP

类风湿关节炎患者Th1/Th2细胞平衡的研究 2010-09-06 张浩　朱平　王彦宏　丁景春　陈庆平 摘　要：目的　在单个细胞水平上研究类风湿关节炎(RA)患者滑液及外周血中Th1/Th2细胞平衡状态及其与疾病活动程度的关系。方法　用酶联免疫斑点法(ELISPOT)检测RA患者滑液单个核细胞(SFMC)和外周血单个核细胞(PBMC)的细胞内细胞因子IFN-γ和IL-4的表达情况。结果　RA患者SFMC中Th1及Th1/Th2比值与自身及正常人PBMC相比显著升高(P＜0.01)，Th1/Th2比值与患者Stoke指数呈正相关(r＝0.893，P＜0.01)。结论　在RA患者关节中细胞因子分泌模式朝Th1偏移，Th1/Th2比值与疾病活动性相关，Th1/Th2平衡在RA发病机制及疾病进展中起重要作用。 关键词：关节炎，类风湿；　细胞活素类；　Th1；　Th2；　酶联免疫斑点法 Study on Th1/Th2 balance in patients with rheumatoid arthritis HANG Hao　ZHU Ping　WANG Yanhong　et al （Department of Clinical Immunology,Xijing Hospital,Fourth Military Medical University, Xi′an 710032,China） Abstract：Objective　To study the Th1/Th2 cytokine balance in the synovial fluid and peripheral blood of rheumatoid arthritis (RA) patients and its relationship with the disease activity at the single-cell level.Method　Synovial fluid mononuclear cells (SFMC) and paired peripheral blood mononuclear cells (PBMC) from 9 patients with RA were stimulated for 6 hours with phorbol myristate acetate (PMA) plus ionomycin in the presence of monensin.Cells were stained for intraecllular cytokines such as IFN-γ and IL-4 by enzyme linked immunospot assay (ELISPOT).Results　The mean percentage of Th1 cells and Th1/Th2 ratio were significantly increased in the SFMC compared with the PBMC of paired and 4 healthy individuals (P＜0.01).The Th1/Th2 ratio of SFMC in RA patients correlated significantly with the Stoke Index (r＝0.893,P＜0.01).Conclusion　A shift toward Th1 cytokine profile is observed in the joints of RA patients and Th1/Th2 ratio correlates well the disease activity. Th1/Th2 cytokine balance has important implication in the pathogensis and development of RA. Key words：Arthritis,rheumatoid;　Cytokines;　Th1;　Th2;　Enzyme linked immunospot assay▲ 　　类风湿关节炎(RA)是一种以慢性炎症性多关节炎为主要表现的全身性疾病，其特征为以大量T淋巴细胞浸润为主的慢性滑膜炎。RA的发病机制目前仍不清楚，但T细胞尤其是辅助性T细胞(Th1/Th2)在RA发病中的作用越来越受到重视，炎症局部的Th1/Th2细胞因子模式能够影响疾病的进程［1］。但在单个细胞水平上对Th细胞亚群平衡状态的研究还很少。我们利用酶联免疫斑点法(enzyme linked immunospot assay，ELISPOT)在单个细胞水平上检测了RA患者滑液