Flow Cytometric Analysis of Lymphocyte Subpopulations and Th1/Th2 Balance in Patients with Polymyositis and Dermatomyositis
Flow Cytometric Analysis of Lymphocyte Subpopulations and Th1/Th2 Balance in Patients with Polymyositis and Dermatomyositis
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DOI：
10.2169/internalmedicine.47.0967
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发表时间：
2008-01-01
影响因子：
1.2
通讯作者：
Ikeda, Shu-ichi
中科院分区：
文献类型：
--
作者：
Ishii, Wataru;Matsuda, Masayuki;Ikeda, Shu-ichi
目的多发性肌炎（PM）和皮肌炎（DM）是特发性炎症性肌病，自身免疫机制在其发病机制中起重要作用。采用流式细胞仪检测PM和DM患者外周血淋巴细胞免疫细胞化学特征及Th1/Th2平衡。其中，8例DM患者在临床缓解前后进行了检查。入组时无患者接受任何PM或DM治疗。结果PM患者外周血CD3（+）、CD4（+）、HLA-DR+（p <0.01）、CD19（+）、CD23（+）细胞显著高于对照组（p <0.05），而CD3（+）、CD4（+）、CD45RO（+）细胞显著低于对照组（p <0.05）。与对照组相比，DM患者的CD 19（+）（p <0.05）和CD 19 + CD 23（+）细胞（p <0.05）显著增加，CD 4（+）CD 45 RO（+）细胞（p <0.005）和CD 4（+）CD 45 RO（+）/CD 4（+）CD 45 RA（+）比值（p <0.005）显著降低。DM患者的CD4（+）干扰素（IFN）-γ（+）细胞和CD4（+）细胞内IFN-γ/白细胞介素（IL）-4比值显著低于PM患者（p <0.05）或对照组（分别为p <0.0005和p <0.001）。DM患者缓解后CD 4+细胞内IFN-γ/IL-4比值较缓解前显著升高（P <0.05）。结论活动期PM患者外周血B细胞和辅助性T细胞均被激活。Th2细胞在活动性DM的外周血中占主导地位，并且CD4+细胞中的细胞内IFN-γ/IL-4比率可用作指示疾病活动性的临床标志物。
Objective Polymyositis (PM) and dermatomyositis (DM) are idiopathic inflammatory myopathies; autoimmune mechanisms are thought to play an important role in their pathogenesis. We investigated the immunocytochemical characteristics and Th1/Th2 balance of peripheral blood lymphocytes in PM and DM using flow cytometry.Patients and Methods Eight patients with PM and 13 with DM were enrolled in this study. Of these, 8 patients with DM were examined before and after clinical remission. No patients were receiving any treatment for PM or DM at enrollment. Ten healthy subjects were used as controls.Results Patients with PM showed significant increases in CD3(+)CD4(+) HLA-DR+ (p < 0.01) and CD19(+)CD23(+) cells (p < 0.05), and significant decreases in CD3(+)CD4(+) (p < 0.005) and CD4(+)CD45RO(+) cells (p < 0.05) compared with controls. Patients with DM showed significant increases in CD19(+) (p < 0.05) and CD19+ CD23(+) cells (p < 0.05), and significant decreases in CD4(+)CD45RO(+) cells (p < 0.005) and the CD4(+)CD45RO(+)/CD4(+)CD45RA(+) ratio (p < 0.005) compared with controls. CD4(+) interferon (IFN)-gamma(+) cells and the intracellular IFN-gamma/interleukin (IL)- 4 ratio in CD4(+) cells were significantly lower in patients with DM than in those with PM (p < 0.05) or controls (p < 0.0005 and p < 0.001, respectively). The intracellular IFN-gamma/IL- 4 ratio in CD4+ cells was significantly increased in DM after clinical remission compared with before (p < 0.05).Conclusion Both B and helper T cells are activated in peripheral blood of active PM. Th2 cells predominate in peripheral blood of active DM, and the intracellular IFN-gamma/IL- 4 ratio in CD4+ cells may be useful as a clinical marker indicating disease activity.