摘要目的 探讨Th17细胞和CD4+ CD25+ Foxp3+ Treg细胞在系统性红斑狼疮(SLE)患者外周血中的表达及临床意义.方法 选取活动期SLE患者30例(其中狼疮肾炎患者17例)、稳定期SLE患者20例及正常对照者20例为研究对象.运用流式细胞术检测外周血Th17细胞和CD4+CD25+ Foxp3+ Treg细胞的表达,分析其与疾病活动性(SLEDAI评分)、补体C3、CA和肾受累的关系,并进一步与正常对照组比较,分析SLE患者外周血中Th17/Treg细胞比例的变化.结果 (1)Th17细胞在SLE患者外周血的表达为(1.39±0.60)％,正常对照组为(0.80±0.33)％,P＜0.01,而CD4+ CD25+ Foxp3+ Treg细胞的表达两者分别为(3.09±1.54)％和(6.04±1.49)％,P＜0.01;其中,活动期SLE患者外周血Th17细胞的表达高于稳定期SLE患者(P＜0.01)和正常对照组(P＜0.01),CD4+ CD25+ Foxp3+ Treg细胞的表达活动期低于稳定期SLE患者(P＜0.01)和正常对照组(P＜0.01).(2) SLE患者外周血Th17细胞和CD4+ CD25+ Foxp3+ Treg细胞的异常表达与疾病活动度和肾损害有相关性.(3)活动期SLE患者Th17/Treg细胞比值较稳定期SLE患者和正常对照组增高(P＜0.01),并与SLEDAI评分呈正相关.结论 活动期SLE患者外周血中Th17细胞表达增高且伴随CD4+ CD25+ Foxp3+ Treg细胞表达下降.提示Th17细胞分化增多,Treg细胞减少,Th17/Treg细胞比例失衡可导致SLE发病.

abstractsObjective To explore the expression and significance of Th17 and Treg cells in peripheral blood of patients with systemic lupus erythematosus (SLE).Methods Thirty active SLE patients (including 17 SLE patients with lupus nephritis),20 inactive SLE patients and 20 healthy controls were enrolled.The expressions of Th17 cells and CD4 + CD25 + Foxp3 + Treg cells in peripheral blood mononuclear cells (PBMC) were evaluated by flow cytometry.The correlations between the expression of Th17 cells,CD4 + CD25 + Foxp3 + Treg cells and disease activity (SLEDAI),as well as the ratios of Th17 cells and Treg cells (Th17/Treg) in SLE patients and healthy controls were analyzed respectively.Results The expression of Th17 cells in PBMC of SLE patients was higher than that in healthy controls [ ( 1.39 ± 0.60)％ vs (0.80 ± 0.33 )％,P ＜ 0.01 ] while the expression of CD4 + CD25 + Foxp3 + Treg cells decreased in SLE patients [ (3.09 ± 1.54) ％ vs (6.04 ± 1.49) ％,P ＜ 0.01 ].The increased expression of Th17 cells and reduced CD4 + CD25 + Foxp3 + Treg cells in PBMC were positively correlated with SLEDAI and negatively correlated with complements C3 and C4.There were increased expression of Th17 cells and reduced CD4 + CD25 + Foxp3 + Treg cells in PBMC of lupus nephritis versus SLE patients without nephritis.Conclusion There is an abnormal elevation of Th17 cells and decrease of CD4 + CD25 + Foxp3 + Treg cells in PBMC of SLE patients.The imbalance between Thl7 and Treg cells may play a critical role in the pathogenesis of SLE.