摘要
目的通过研究原发性胆汁性肝硬化(PBC)患者与非酒精性脂肪性肝炎(NASH)患者外周血和肝脏内淋巴细胞及其活化状态(分子标记:HLADR+CD3+)、初始T细胞(CD45RA)、记忆T细胞(CD45RO)及趋化因子受体CXCR3,了解肝内淋巴细胞活化状态及其影响因素。方法流式细胞法检测两种肝病患者外周血和肝内淋巴细胞分子标记CD3、CD4、CD8、HLADR+CD3+、CD45RA、CD45RO、CXCR3,进行统计分析。结果 PBC患者在外周血中以CD4+T淋巴细胞为主,肝内浸润淋巴细胞CD8+T和CD4+T淋巴细胞无明显差异;肝内与外周血比较:CD4+T淋巴细胞明显减少,CD4/CD8比例明显降低,HLADR+CD3+T淋巴细胞差异无显著性,CD45RA明显低于外周血,CD45RO则差异无显著性,CXCR3高于外周血中。与NASH患者比较:PBC患者肝内CD4+T细胞增多,CD4/CD8上升,HLADR+CD3+增高,CD45RO、CD45RA减少,CXCR3增多;外周血T淋巴细胞及HLADR+CD3+两组间差异无显著性,CD45RA减少,CXCR3两组间差异无显著性。结论 PBC患者外周血淋巴细胞及其活化状态与肝内免疫状况有关;肝内CD4+T淋巴细胞较NASH患者增多,提示CD4+T的活化和增殖是PBC发生和发展的关键环节;记忆性T淋巴细胞数量(CD45RO)控制在一定范围内可能是自身免疫反应得以不断进行的原因;CXCR3与T淋巴细胞向肝脏定向迁徙有关。
Objective To explore the state of lymphocyte activation and influential factors of PBC patients. Methods Intrahepatic and PBL CD3,CD4,CD8,CD4/CD8,HLADR＋CD3＋,CD45RA,CD45RO and CXCR3 positive cells in PBC and NASH patients were detected with flow cytometric analysis. Results CD4＋ T cells were the most abundant lymphocytes in peripheral blood in PBC,while CD8＋ and CD4＋ T lymphocytes represented the main subsets in liver.Compared to the lymphocytes in the blood of PBC patients,significant reduction of CD4＋ and CD45RA T cells and ratio of CD4 to CD8 was observed in liver.No significant difference was found in the frequency of HLADR＋CD3＋ and CD45RO between peripheral blood and liver.Furthermore,expression of CXCR3 was significantly higher in IHL than that in PBL.Intrahepatic CD4＋ and HLADR＋CD3＋ T cell counts and the ratio of CD4 to CD8 were significantly increased in PBC patients compared those in NASH patients,with significant reduction of CD45RA and CD45RO counts and increase of CXCR3 expression.No significant difference was found in peripheral blood HLADR＋CD3＋ cell count or CXCR3 expression between PBC and NASH patients.However,significant reduction of peripheral blood CD45RA cell count was observed in PBC patients. Conclusion Activation and peripheral blood lymphocyte count is correlated to the immune state of liver.The activation and proliferation of CD4＋ T cells in the liver may be the critical element in pathogenesis of PBC.CXCR3 may play an important role in hepatic migration of T lymphocyte.The relatively stable memory T lymphocyte count takes responsibility to prolonging of the autoimmune response.
出处
《广东医学》
CAS
CSCD
北大核心
2010年第23期3044-3047,共4页
Guangdong Medical Journal
基金
云南省科技计划国际合作项目(编号:2006GH14)
