双阴性T 细胞对抗中性粒细胞胞质抗体 相关性血管炎的影响

Influence of double-negative T cells on ANCA associated vasculitis

摘要:

目的 分析抗中性粒细胞胞质抗体相关性血管炎（AAV）患者外周血中双阴性T 细胞（DNT）的 表达情况。方法 选取50 例AAV 患者（AAV 组），按照疾病活动情况分为活动组36 例和缓解组14 例；按照 有无肾损害分为肾损害组32 例和非肾损害组18 例。同期招募30 例健康志愿者作为对照组。比较AAV 组患者 与对照组DNT 细胞及胞内细胞因子白细胞介素17（IL-17）、白细胞介素4（IL-4）和γ 干扰素（IFN-γ） 水平的差异及与患者临床指标的相关性。结果 AAV 组患者DNT、IL-17 及IFN-γ 水平高于对照组（P <0.05）， 而IL-4 低于对照组（P <0.05）。AAV 患者活动组DNT、IL-17 水平高于缓解组（P <0.05）。AAV 患者肾损害 组DNT 和IL-17 水平高于非肾损害组（P <0.05）。AAV 患者DNT 与红细胞沉降率（ESR）、血清肌酐（Scr）、 24 h 尿蛋白、伯明翰评分、抗中性粒细胞胞质抗体滴度呈正相关（P <0.05）；IL-17 与Scr、24 h 尿蛋白呈正相 关（P <0.05），而IL-4、IFN-γ 与临床指标无相关性（P >0.05）。结论 DNT 与AAV 的发病有相关性。

Abstract:

Objective To analyze the expression level of double-negative T cells in peripheral blood of patients with ANCA-associated vasculitis (AAV). Methods Fifty patients with ANCA-related vasculitis were selected . They were divided into active group (n = 36), inactive group (n = 14), renal damage group (n = 32) and non-renal damage group (n = 18). At the same time, thirty healthy volunteers were taken as control group. The levels of DNT cells, IL-17, IL-4 and IFN-γ in DNT cells were compared between normal persons and different types of AAV patients. Correlation between the level of DNT cells and the levels of IL-17, IL-4, IFN-γ in patients with AAV and clinical indicators were analyzed. Results The expression levels of DNT cells and IL-17, IFN-γ in AAV patients were higher than those of normal persons, while the level of IL-4 was lower than that of normal persons (P < 0.05). The levels of DNT cells and IL-17 in AAV active group were higher than those in non-active group (P < 0.05). The levels of DNT cells and IL-17 in AAV patients with renal impairment were higher than those in non-renal impairment patients (P < 0.05). In AAV patients, DNT was positively correlated with ESR, creatinine, 24-hour urinary protein and Birmingham score; IL-17 was positively correlated with creatinine and 24-hour urinary protein, while IL-4 and IFN-γ were not correlated with all clinical indicators. Conclusions DNT cells are associated with the incidence of ANCA-associated vasculitis.