摘要目的 观察类风湿性关节炎(RA)患者外周血Th17细胞与CD4+CD25+FoxP3+调节性T细胞(Treg)平衡状态与疾病的关系,分析Th17/Treg细胞免疫失衡在RA发病机制中的作用.方法 采用流式细胞仪四色荧光抗体标记法分别对47例RA患者和39名健康志愿者(HVs)进行CD3、CD8、IL-17与CD4、CD25、FoxP3标记,测定Th17与调节性T细胞的比例变化及相关细胞因子IL-6、IL-23和IL-17水平.结果 RA组患者外周血中,CD3+CD8-IL-17+T细胞占CD3+T淋巴细胞的百分比为(1.12±0.38)%,明显高于对照组(0.68±0.29)%(t=1.83,P＜0.05);CD4+CD25+FoxP3+细胞占CD4+T淋巴细胞的百分比为(2.74±0.71)%,明显低于对照组(4.69±1.23)%(t=-2.94,P＜0.05).相关细胞因子测定结果:IL-6水平在RA组为(13.5±3.7)ng/L,正常人为(4.6±0.9)ng/L(t=6.24,P＜0.01);IL-23水平在RA组为(71±19)ng/L,正常人为(25±6)ng/L(t=14.37,P＜0.01);IL-17水平在RA组为(122±33)ng/L,正常人为(37±9)ng/L(t=19.01,P＜0.01);RA患者血清IL-6、IL-23和IL-17水平均明显升高.结论 RA患者外周血Th17与CD4+CD25+FoxP3+调节性T细胞数量的异常可能是RA发病的重要因素,IL-6和IL-23的升高是引起这些改变的可能原因.

abstractsObjective To observe the relationship between balance of peripheral blood Th17 cells and CD4 + CD25 + FoxP3 + regulatory T(Treg) cells in patients with rheumatoid arthritis (RA), and to analyze the role of Th17/Treg cell imbalance in the pathogenesis of RA. Methods Four-color flurescence flow cytometry was used to detect the CD3,CD8,IL-17 and CD4,CD25, FoxP3 markers in the peripheral blood of 47 patients and 39 healthy volunteers(HVs) . The proportions of Th17 cells and CD4 + CD25 + FoxP3 + regulatory T cells were compared between the two groups. IL-6, IL-23 and IL-17 in sera of these subjects were tested by ELISA.Results The quantity of CD3 + CD8-IL-17 + cells in RA patients was significantly higher than those in normal control[(1. 12 ± 0. 38) % vs. (0.68 ± 0.29) %; t = 1.83, P ＜ 0.05)]and the proportions of CD4 + CD25 +FoxP3+ cells were significantly lower in RA group compared with HV group[(2.74 ±0.71)% vs. (4.69 ±1.23) %; t = - 2. 94, P ＜ 0.05]. Meanwhile , IL-6, IL-23 and IL-17 in sera of RA were (13.5 ± 3.7)ng/L, (71 ± 19) ng/L and (122 ± 33) ng/L respectively. These three cytokines in healthy controls were (4.6±0.9) ng/L (t =6.24, P＜0.01),(25 ±6) ng/L (t =14.37,P＜0.01), and (37±9) ng/L (t =19.01,P＜0. 01) respectively. IL-6,IL-23 and IL-17 increased significantly in RA patients as compared with healthy donors. Conclusion This study suggested that abnormality of Th17 and CD4 + CD25 + FoxP3 + Tregs might depend on the increased IL-6 and IL-23 and it may play a critical role in the incidence of RA.