【作者】 沈斌；

【导师】 许冰；

【作者基本信息】 浙江大学 ， 皮肤性病学， 2002， 硕士

【摘要】 一、研究背景和目的 系统性红斑狼疮(SLE)是一种发病机制未明的系统性自身免疫性疾病，其特征是体内产生多种自身抗体，提示自身耐受的破坏和自身反应性T、B细胞的过度活化。免疫应答过程中T、B细胞的活化除了需要抗原与T、B细胞受体结合提供的第一信号外，尚需要共刺激分子提供的第二信号。B7分子包括B7-1(CD80)、B7-2(CD86)和B7-3，它作为一种重要的共刺激分子在T、B细胞的活化、抗体的产生和免疫耐受的诱导中起着重要的作用。近来有实验表明，SLE患者外周血淋巴细胞(PBLC)表达B7分子异常，阻断B7-CD28信号通路在狼疮动物模型上取得了良好的治疗效果。但各家报道结果不一。为此，我们对SLE患者PBLC上CD80和CD86分子的表达进行了研究，以探讨其在SLE发病中的作用。 渴51大9 0曹戍I阮在9井B位币士伦吏 二、研究对级和方法 1、研究对象 确诊SLE患者30例（男6例，女24例；平均年龄37．6士15．二岁），均 符合 1982年美国风湿病协会修订的 SLE诊断标推，其中 28例病人服用激素 治疗，剂量相当于泼尼松 10七0呛d，采用 SLE疾病活动指数（SLEDAl评分 法评估疾病活动程度。正常对照组25例，其中男5例，女20例，平均年龄 33．5士15．吕岁。 二、方祛 流式细胞仪检测。 3、统计学处理 两均数比较采用 MalmBOllt’ley U检验，相关分析采用 Spearman等级相关分析，实验结果用x士s表示，所有处理均在SPSS 10．0软 件上进行。 三、结果 1、SLE患者P＊＊C上＊＊86的表达显著低于正常对照组（P＜0刀5）；＊＊so 表达与正常对照组无明显差异； 二、SLE患者活动期和非活动期、有肾病组和无肾病组的CD80和CD86 的表达均无明显差异； 3、CD80和 CD86水平与 SLE疾病活动指数（SLEDAl）、ANA滴度、 IgG、和C3水平无相关关系。 一2 一 钙5二丈管医学戍临在毒公学佰项士伦丈 四、结论 l、SLE患者PBLC上CD86的表达降低，可能与SLE发病机制有关。 2、测定SLE患者PBLC上CD80和CD86的表达水平不能判断疾病的活 动程度和预测肾损害的发生。更多还原

【Abstract】 Background and ObjectiveSystemic lupus erythematosus(SLE) is a systemic disease characterized by generalized autoimmunity consisting of hyperactive T cells help and hyperactive B cell synthesis of immunoglobulins. It’s etiopathogenesis remains vague. T cell activation requires at least two distinct signals. The first signal is interaction of the antigen-specific T cell receptor with its antigen presented on MHC. The secondsignal is received from interaction with costimulatory molecules. As a most important costimulatory molecules, B7 family, which includes B7-1(CD80), B7-2(CD86) and B7-3, plays a very important role in the activation of T/B cells, production of autoimmune antibodies and immune anergy. A number of recent studies report abnormal expression of CD80 and CD86 molecules from patients with SLE. By blocking the CD28-B7 pathway, great progress in treatment have been made in animal model. An implication of these studies is that altered expression of costimulatory molecules may contribute to a loss of self-tolerance and disease development. But the results of these studies were not consistent. To investigate the expression of costimulatory molecules CD80 and CD86 on peripheral blood lymphocytes (PBLC) in patients with systemic lupus erythematosus and its significance, We perform the experiment.Patients and MethodsPatients:30 patients with established SLE(24 women and 6 men, age 37.6+15.2 years) and 25 normal individuals(20 women and 5 men, age33.5?5.8 years) werestudied. All patients met the ACR criteria for SLE. 28 patients were receivingprednisone in doses 10-60mg/day. Activity of disease were valued by SystemicLupus Erythematosus Disease Activity Index (SLEDAI).Methods: Flow cytometric assay was used.Statistics: Statistical analysis of the data was performed using software SPSS 10.0.Means SEM was used and differences was compared using the Mann-WhitneyU test, correlation was analyzed by Spearman’s rank test.Results1, Expression of CD86 on PBLC in patients with SLE was significantly lower than that of normal controls ( P <0.01).2, No significant difference was observed between SLE patients and normal controls in CD80 expression.3,There was no difference of expression of CD80 and CD86 on PBLC betweenSLE patients with and without kidney disease. 4,The CD80 and CD86 levels of active SLE patients were similar with that ofinactive SLE patients and were not correlated with the SLEDAI scores, ANAliters, IgG and C3 serum levels.Conclusion1, Expression of CD86 on PBLC in SLE patients was decreased, which may be related to the pathogenesis of SLE.2, Measuring the level of CD80 and CD86 on PBLC can’t determine the activity of disease and predict the development of kidney disease in patients with SLE.更多还原