摘要
目的探讨外周血滤泡辅助性T细胞(T follicular helper cells,Tfh细胞)及其亚类失衡在儿童过敏性紫癜(HenochSch?nlein purpura,HSP)及紫癜性肾炎(HSP nephritis,HSPN)发生发展中的作用及可能机制。方法收集确诊的HSP患儿45例,根据肾脏受累情况分为3组:无肾脏受累组(A组)21例,孤立性血尿组(B组)12例,血尿合并蛋白尿组(C组)12例,另收集同期在我院健康体检儿童17例为对照组。采用流式细胞术检测外周血中Tfh(CD3^+CD4^+CXCR5^+)细胞及其亚类Tfh1(CCR6^-CXCR3^+Tfh),Tfh2(CCR6^-CXCR3^-Tfh),Tfh17(CCR6^+CXCR3^-Tfh)比例,同时检测ICOS及OX40在Tfh细胞及其亚类上表达情况。结果与对照组相比,A组和C组Tfh细胞及表达ICOS水平都明显增高(P<0.05);C组Tfh2细胞、(Tfh2^+Tfh17)/Tfh1、Tfh细胞OX40和ICOS表达、Tfh2细胞ICOS表达均上调,而Tfh1细胞水平下调,差异有统计学意义(P<0.05);A组和B组Tfh1细胞、Tfh2细胞、Tfh17细胞及这些亚类细胞上ICOS和OX40表达,均无统计学差异(P>0.05)。HSP各组间比较,C组Tfh细胞比例较A、B组有增高的趋势,但差异无统计学意义,A组和B组间Tfh细胞无差异(P>0.05)。进一步发现外周血Tfh细胞、Tfh2细胞、Tfh细胞上ICOS和OX40表达与血清IgA水平成正相关,而Tfh1细胞与IgA水平成负相关,Tfh17细胞与IgA无相关性。结论 Tfh亚类紊乱(Tfh2增加,Tfh1降低)参与了HSP及HPSN发生。而Tfh可能通过ICOS和OX40信号通路参与HSP高IgA血症,但其具体机制尚待进一步研究。
The aim of this study was to examine the frequency of different subsets of T follicular helper （Tfh） cells in children with Henoch-Schonlein purpura （HSP）, and explore the role of Tfh in HSP. Total of 45 children with HSP were classified into three groups as followed： 21 HSP children without renal involvement （group A）, 12 HSP nephritis （HSPN） children with only microhematuria （group B）, 12 HSPN children with proteinuria （group C）, while 17 healthy children were recruited as controls （HC）. Flow cytometry was employed to detect the percentage of Tfh （CD3＋CD4＋CXCR5＋） cells, Trial （CCR6-CXCR3＋Tfh）, Tfh2 （CCR6-CXCR3-Tfh）, Tfh17 （CCR6＋CXCR3-Tfh）, ICOS, and OX40 in peripheral blood from the patients. Data showed that compared with control, the percentage of circulating Tfh cells were significantly higher in group A and C （P〈0.05）, Tfh2 cells, the ratio of Tfh2＋Tfhl7 to Tfhl, the MFI of ICOS in Tfh cells and Tfh2 cells, OX40＋Tfh cells were significantly increased in group C, MFI of ICOS in Tfh cell was increased in group A, while there were no significant difference in the percentage of Tfhl ,Tfh2, Tfhl7 and the expression of ICOS and OX40 in Tfh subsets between group A and B （P〉 0.05）. Moreover, the percentage Tfh cells, Tfh2 cells, MFI of ICOS in Till and OX40＋Tfh were positively correlated with serum IgA , while Tfhl cells were negatively correlated with serum IgA. In conclusion, increased circulating Tfh cells and imbalanced Tfh subsets play a significant role in development of Henoch-Schonlein purpura （HSP）. Overexpression of ICOS and OX40 may be a underlying mechanism of abnormal activation of Tfh.
出处
《免疫学杂志》
CAS
CSCD
北大核心
2018年第2期120-127,共8页
Immunological Journal
基金
国家自然科学基金(81470946
81770713)
