【作者】 卞华； 吕芹； 毛秉豫；

【Author】 Bian Hua~1,Lv Qin~2,Mao Bing-yu~1 (1.ZhangZhongjing College of Chinese Medicine of Nan yang Institute of Technology,Nan yang, 473004,Henan,China,;2.Nan yang Medical College,Nanyang,473061,Henan,China)

【机构】 南阳理工学院张仲景国医学院； 南阳医学高等专科学校；

【摘要】 目的:探讨CD28/B7在系统性红斑狼疮(SLE)发病中的作用及解毒祛瘀滋阴方治疗SLE的分子免疫学机制。方法:63例SLE患者随机分为2组:西医组(32例)采用强的松、环磷酰胺治疗;中西医结合组(31例)采用滋阴解毒通络联合强的松、环磷酰胺治疗,均治疗3个月。另选20例健康女性作为正常对照。运用流式细胞仪检测外周血单个核细胞(PBMC)表面CD28、B7-1、B7-2的表达水平。结果:与正常对照组比较,治疗前不同病情SLE患者PBMC表面CD28的表达水平均显著降低(P<0.05或P<0.01),而B7-1和B7-2的表达明显增加(P<0.01)。治疗后中西医结合组能显著降低B7-1、B7-2的表达(P<0.05,P<0.01),升高CD28的表达(P<0.01),且B7-2分子的的改善优于治疗后西医组(P<0.05)。同时SLE患者PBMC表面B7-2分子表达水平与SLE病情活动指数呈直线正相关(r=0.76,P<0.01);B7-1及CD28与SLEDAI无明显相关性。结论:CD28/B7共刺激途径在SLE的发生和发展过程中起着重要作用,通过影响CD28/B7共刺激信号传导可能是滋阴解毒通络治疗SLE的机理之一。更多还原

【Abstract】 Objective:To observe the role of D28/B7 in systemic lupus erythematosus (SLE) and explore the mechanism of Ziyin Jiedu Tongluo Methods(ZYJDTLM)treatment.Methods: Sixty-three mild to moderate patients with SLE were randomized into two groups.Western medicine group(32cases) were treated with prednisone and cyclophosphamide(CTX). Integrated Chinese and western medicine group(31cases) were treated with ZYJDTLM combined with prednisone and CTX.These SLE patients were observed for three months.The expression of CD28 and B7-1and B7-2 in PBMC from patients with SLE were detected by using the techniques of immunofluorescence and flow cytometry.Results:The percentage of CD28 in PBMC from different patients with SLE before treatment was lower than that in normal control group(P<0.05).The percentage of B7-1 and B7-2 in PBMC from different patients with SLE before treatment were higher than that in normal control group(P<0.01).There was a positive linear correlation between the level of B7-2 and SLEDAI(r=0.76,P<0.01).But a positive correlation between SLEDAI and the levels of CD28 and B7-1 was not found.After treatment integrated Chinese and western medicine therapy significantly increased the level of CD28 and decreased the levels of B7-1 and B7-2 in PBMC(P<0.01 or P<0.05).And integrated Chinese and western medicine group markedly decreased the level of B7-2 in PBMC compared with western medicine group(P<0.05).Conclusions:CD28/ B7 play an important role on pathogenesis of SLE.Inhibiting CD28/B7 costimulatory signal transduction pathway may be pharmacologic mechanism of ZYJDTLM in the treatment of SLE.更多还原