摘要
背景 蚕蚀性角膜溃疡是免疫性角膜疾病,治疗效果不佳,其发病机制尚未完全明确.研究表明,外周血CD4＋淋巴细胞亚群辅助性T细胞（Th）1型和2型细胞的平衡失调在相关的自身免疫性疾病中发挥作用,但其与蚕蚀性角膜溃疡发生和发展的关系尚不清楚. 目的 比较活动期蚕蚀性角膜溃疡患者外周血Th1和Th2细胞比例的变化. 方法 纳入2012年1月至2013年7月在中山大学中山眼科中心确诊的活动期蚕蚀性角膜溃疡患者11例,同期在同一医院体检的健康职工8人作为对照.抽取受检者外周血10 ml分离外周血单核细胞（PBMCs）,用流式细胞仪测定PBMCs中Th细胞亚群的比例;采用实时荧光定量PCR（RT-qPCR）法测定受检者PBMCs中T-bet、GATA-3、信号传导子及转录激活子5（Stat5） mRNA的相对表达量.结果 蚕蚀性角膜溃疡组患者PBMCs中Th1细胞所占CD4＋细胞的百分比及Th1/Th2的比值分别为0.21％（0.11％,0.31％）和8.01（4.49,12.01）,明显低于正常对照组的0.35％ （0.22％,0.71％）和23.90（22.49,33.49）,差异均有统计学意义（Z=-2.01,P=0.04;Z=-3.06,P=0.00）;蚕蚀性角膜溃疡组患者PBMCs中Th2细胞所占CD4＋细胞的百分比为0.02％ （0.02％,0.03％）,与正常对照组的0.01％ （0.01％,0.02％）比较差异无统计学意义（Z=-1.98,P＞0.05）.与正常对照组比较,蚕蚀性角膜溃疡组患者PBMCs中T-bet mRNA、GATA-3 mRNA的相对表达量明显下降,差异均有统计学意义（Z=-3.47、-3.06,均P=0.00）,两个组间Stat5mRNA的相对表达水平差异无统计学意义（Z=-1.05,P=0.33）.结论 活动期蚕蚀性角膜溃疡患者外周血Th1及Th2细胞所占的CD4＋细胞百分比与相关转录因子的含量均发生明显变化,提示Th1细胞及Th2细胞与蚕蚀性角膜溃疡的发病有关.
Background Mooren ＇s ulcer is an immune-related corneal inflammatory disease,and its pathogenesis remains below understood.Previous studies showed that the imbalance of T helper cell type 1 （Th1） and Th2 cell play important roles in the development of some autoimmune diseases.Thereby the influence of Th1/Th2 cells on the pathogenesis of Mooren＇s ulcer is being concerned.Objective This study was to investigate the change of Th1 and Th2 subsets in periphery blood of patients with active Mooren＇s ulcer.Methods Eleven consecutive patients with active Mooren＇s ulcer and 8 age-and gener-matched healthy controls were included in Zhongshan Ophthalmic Center,Sun Yat-sen University from January 2012 to July 2013 under the approval of Ethic Committee of this hospital and informed consent of each subject.The peripheral blood samples of all the subjects were obtained separately and periphery blood mononuclear cells （PBMCs）were isolated.The percentages of Th1 and Th2 in the PBMCs were assayed by flow cytometer.The relative expressions of T-bet mRNA,GATA-3 mRNA and signal transducer and activator of transcription 5 （Stat5） mRNA in the PBMCs were examined and compared by real-time fluorescence quantitative PCR （RT-qPCR） Results The percentage of Th1 cells in CD4＋ T cells and Th1/Th2 value was 0.21％ （0.11％,0.31％） and 8.01 （4.49,12.01） respectively in the Mooren＇s ulcer group,which were significantly lower than 0.35％ （0.22％,0.71％）and 23.90 （22.49,33.49）in the normal control group,respectively （Z =-2.01,P =0.04 ; Z =-3.06,P =0.00）.However,no significant difference was found in the percentage of Th2 between the two groups （Z=-1.98,P＞0.05）.The relative expressions of T-bet mRNA and GATA-3 mRNA in PBMCs were significantly lower in the Mooren＇s ulcer group than those in the normal control group （Z =-3.47,-3.06,both at P=0.00） ;While the relative expression of Stat5 mRNA in PBMCs was insignificant changed between the two groups （Z =-1.05,P =0.33）.Conclusions Th1 and Th2 cells are unbalanced in the active Mooren＇s ulcer patients.In addition,the down-expression of relevant transcription factors in peripheral blood also is seen in these patients.It is inferred that Th1 and Th2 cells may participate in the progress of Mooren＇s ulcer.
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2014年第12期1074-1079,共6页
Chinese Journal Of Experimental Ophthalmology
基金
广东省科技计划项目（201180318000295）
