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类风湿关节炎患者Th1 Th2细胞平衡的研究

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

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