【摘要】 目的 探讨重症肌无力(MG)患者外周血B淋巴细胞中叉头框蛋白P1 (FOXP1) mRNA表达水平和临床意义。方法 收集34例MG患者及24例健康体检者(健康对照组)的静脉血样，并根据MG患者病情程度将其分为眼肌型重症肌无力(OMG)组和全身型重症肌无力(GMG)组，根据定量重症肌无力(QMG)量表评分。荧光实时定量PCR检测CD19~+ B细胞中FOXP1 mRNA的表达水平，流式细胞术检测外周血中CD138~+浆细胞的表达频率，间接ELISA法检测血清IgG型抗乙酰胆碱受体(AChR)抗体滴度。分析OMG组和GMG组CD19~+B细胞中FOXP1 mRNA的表达水平与QMG评分、CD138~+浆细胞频率、抗AChR抗体滴度的相关性。结果 与健康对照组相比，OMG组和GMG组外周血CD19~+B细胞中FOXP1 mRNA表达水平均降低，抗AChR抗体滴度均增加，差异有统计学意义(P<0.01),且GMG组变化较OMG组更为显著(P<0.01)。OMG组和GMG组外周血CD19~+B细胞中FOXP1 mRNA的表达水平与QMG评分、CD138~+浆细胞频率、抗AChR滴度均呈显著负相关。结论 FOXP1在MG患者B细胞中表达减少，与临床严重程度及浆细胞频率负相关，提示FOXP1可能在B细胞向浆细胞分化中发挥负调控作用。更多还原

【Abstract】 Objective To detect the level of FOXP1 mRNA in peripheral blood B lymphocytes of patients with myasthenia gravis(MG) and to explore the clinical significance of FOXP1 in MG. Methods A total of 34 MG patients and 24 healthy subjects(a control group) were included into the current study. The MG patients were sub-divided into two groups: an ocular myasthenia gravis(OMG) group and a general myasthenia gravis(GMG) group. Both the QMG and GMG groups were scored using the quantitative MG(QMG) scale. The level of FOXP1 mRNA in CD19~+ B cells was determined by quantitative real-time PCR. The frequencies of CD138~+ plasma cells were detected by flow cytometry. The titers of anti-acetylcholine receptor(AchR)-IgG were tested by ELISA. Meanwhile, the associations between the level of FOXP1 mRNA in CD19~+ B cells in the OMG and GMG groups and QMG scores, the frequencies of CD138~+ plasma cells and the titers of anti-AchR-IgG were analyzed. Results Compared with the control group, the OMG and GMG groups produced reduced levels of FOXP1 mRNA in CD19~+ B cells, increased frequencies of CD138~+ plasma cells and higher anti-AchR-IgG titers(each P<0.01). Meanwhile, the changes in the GMG group was more remarkable than those in the OMG group(each P<0.01). The level of FOXP1 mRNA in CD19~+ B cells was negatively associated with QMG scores, CD138~+ plasma cell frequency and anti-AchR-IgG titers. Conclusion The decreased expression of FOXP1 mRNA in B cells of MG patients is negatively associated with clinical severity and plasma cell frequency, indicating the potential role of FOXP1 in negative regulation of the differentiation of B cells into plasma cells in the pathogenesis of MG.更多还原