【摘要】 目的研究重症肌无力（MG）患者外周血多群调节性 T 细胞的水平及其 B 细胞表达 B细胞激活因子受体（B cell-activating factor receptor,BAFF-R）的情况。方法应用四色流式细胞仪检测61例 MG 患者与23名健康对照外周血调节性 T 细胞(CD₄⁺ CD₂₅^highFoxp3⁺、CD₈⁺CD₂₈^-、CD₈⁺CD₁₂₂⁺)以及 CD₁₉⁺BAFF-R⁺细胞的百分率。结果 MG 组与健康对照组外周血 CD₄⁺CD₂₅^highFoxp3⁺T 细胞的百分率分别为32.12%±16.12%与65.15%±14.72%,MG 组该群调节性 T 细胞的水平明显低于健康对照组（P<0.01）;两组 CD₈⁺CD₂₈^-及 CD₈⁺CD₁₂₂⁺T 细胞的水平差异无统计学意义。此外,MG 组外周血CD₁₉⁺BAFF-R⁺细胞的水平（10.57%±5.59%）显著高于健康对照组（5.38%±3.87%,P<0.01）。大剂量激素或大剂量激素加丙种球蛋白治疗后短期内可使 MG 组外周血 CD₄⁺CD₂₅^highFoxp3⁺调节性 T 细胞的百分率增加（P<0.05）。结论 MG 患者 Foxp3⁺的 CD₄⁺CD₂₅^high调节性 T 细胞的减少提示 MG 患者存在免疫和耐受的失衡,显示了 T 细胞的自身免疫性。在 B 细胞方面,MG 患者外周血 CD₁₉⁺B 细胞上 BAFF-R 表达增高,提示其体内 B 细胞已处于易激活状态。更多还原

【Abstract】 Objectives To investigate the levels of circulating regulatory T cells and B cell- activating factor receptor （BAFF-R） on B cells from patients with myasthenia gravis （MG）.Methods The levels of circulating regulatory T cells(CD₄⁺CD₂₅^highFoxp3⁺,CD₈⁺ CD₂₈^-,CD₈⁺ CD₁₂₂⁺) and CD₁₉⁺BAFF-R⁺ cells in 61 MG patients and 23 healthy controls were tested with flow cytometry.Results The percentages of the circulating CD₄⁺CD₂₅^highFoxp3⁺ T cells （65.15%±14.72%） in MG patients were significantly decreased compared with healthy controls（32.12%±16.12%,P<0.01）.The expression of BAFF-R on CD₁₉⁺B cells in MG patients （10.57%±5.59%） was higher than that in healthy controls （5.38%±3.87%,P< 0.01）.There was no significant difference in the subpopulation of CD₈⁺CD₂₈^-and CD₈⁺CD₁₂₂⁺T cells between MG patients and healthy controls.Treatment of high-dose corticosteroid with or without additional intravenous IgG elevated the percentages of CD₄⁺CD₂₅^highFoxp3⁺T cells in 20 MG patients （P<0.05）.Conclusions These results reveal that decrease of circulating CD₄⁺CD₂₅^highFoxp3⁺ regulatory T cells in MG patients might be related to the pathogenesis of MG.An elevated BAFF-R on CD₁₉⁺ B cells demonstrates that B cells are more active in MG patients.更多还原