The analysis of adhesion molecule and chemokine on lymphocytes in inflammatory bowel disease patients

我们招募了36例活动性克罗恩病（CD）和33例溃疡性结肠炎（UC）患者进行本研究。CD组11例接受英夫利昔单抗（IFX）治疗，19例接受全肠外营养（TPN）治疗，6例接受泼尼松龙（PSL）治疗。在UC中，16例患者接受PSL治疗，17例患者接受白细胞去除术治疗。治疗前后每隔4周检测一次外周血单个核细胞（PBMCs）。以克罗恩病活动指数（CDAI）和溃疡性结肠炎活动指数（UCAI）小于150为疗效标准。从每个受试者获得血液样品，并通过密度梯度分离分离PBMC。用抗CD 4、抗CD 8、LFA-1、CCR 5、CXCR 3等抗体对PBMC进行染色，用FACSCalibur和CellQuest程序分析。 ...更多信息 各组治疗前后CD、UC的疗效比较差异有统计学意义。PSL组LFA-1表达水平（1476±381）与白细胞单采组（1685±407）比较差异无统计学意义。而CD在IFX组、TPN组、PSL组和白细胞单采组之间差异无统计学意义。治疗后，PSL组和白细胞单采组的UC患者PBMC上LFA-1的表达无明显差异。而CD患者TPN组治疗前后LFA-1表达水平无明显下降，且LFA-1平均表达水平由治疗前的1685±479上升至治疗后的1902±562。结论TPN治疗对LFA-1的表达无影响，IFX、PSL白细胞去除术可降低LFA-1的表达。各治疗组治疗前后病情活动度无明显差异。这些结果表明，PSL，IFX和白细胞去除治疗通过LFA-1信号通路降低疾病活动性，TPN治疗通过不同的机制降低疾病活动性。少

Patients and methodsWe recruited 36 patients with active Crohn's disease (CD) and 33 patients with ulcerative colitis (UC) for the present investigation. In CD, 11 patients were treated by infliximab (IFX), 19 patients were treated by total parenteral nutrition(TPN)and 6 patients were treated by predonisolone(PSL). In UC, 16 patients were treated by PSL and 17 patients were treated by leukocytapheresis. The interval that peripheral blood mononuclear cells(PBMCs)were assessed both before and after treatment was 4 weeks. The therapeutic efficacy was regarded to be efficacious when Crohn's disease activities index (CDAI) and ulcerative colitis activity index (UCAI) was less than 150. A blood sample was obtained from each subjected and PBMCs were isolated by density gradient separation. The PBMCs were stained appropriate antibody that were anti-CD4, anti-CD8, LFA-1, CCR5 and CXCR3.All sample were analyzed by FACSCalibur and CellQuest program.ResultsThe disease activities were not significa … More ntly different among all groups before treatment and after treatment in CD and UC. The expression level of LFA-1 was not statistically difference between PSL group (1476±381) and leukocytapheresis group (1685±407) in UC at baseline. And in CD, there were no significantly difference among the IFX, TPN, PSL and leukocytapheresis group at baseline. After the treatment, in UC, the expression of LFA-1 on PBMCs was not different between PSL group and leukocytapheresis. However, in CD, the expression level of LFA-1 on PBMCs in TPN group was not significantly decreased before treatment and after treatment, moreover, the average of the LFA-1 expression level was increased from 1685±479 to 1902±562. On the other hand, in IFX and PSL group, that expression of LFA-1 was decreased statically before and after treatment.ConclusionTPN treatment does not affect the expression of LFA-1 on PBMCs, and IFX, PSL leukocytapheresis reduced the expression of LFA-1 on PBMCs. Disease activity of each treatment group were not different before treatment and after treatment. These results indicate that PSL, IFX and leukocytapheresis treatment reduce disease activity via LFA-1 signaling pathway and TPN treatment reduce disease activity via different mechanism. Less