系统性硬化症患者支气管肺泡灌洗液、外周血及皮肤中单核炎性细胞、CD4/CD8⁺ T细胞、白细胞介素1β和肿瘤坏死因子α的变化
Alterations of mononuclear inflammatory cells, CD4/CD8+ T cells, interleukin 1beta, and tumour necrosis factor alpha in the bronchoalveolar lavage fluid, peripheral blood, and skin of patients with systemic sclerosis.
作者信息
Hussein M R, Hassan H I, Hofny E R M, Elkholy M, Fatehy N A, Abd Elmoniem A E A, Ezz El-Din A M, Afifi O A, Rashed H G
机构信息
Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
出版信息
J Clin Pathol. 2005 Feb;58(2):178-84. doi: 10.1136/jcp.2004.019224.
BACKGROUND
Systemic sclerosis (SSc) is a multisystem disease with underlying immune mechanisms.
AIMS
To investigate the clinicopathological characteristics of the lesions; immunological alterations in the bronchoalveolar lavage fluid (BALF), peripheral blood, and skin; and correlations between the clinicopathological characteristics and immunological alterations in SSc.
MATERIALS/METHODS: Skin biopsies, BALF, and peripheral blood samples were obtained from 19 patients (18 women, one man) with SSc and six age and sex matched healthy controls (HCs). Mononuclear inflammatory cells (MICs), CD4/CD8 cells, tumour necrosis factor alpha (TNFalpha), and interleukin 1beta (IL1-1beta) concentrations were examined in all samples using histological methods, enzyme linked immunosorbent assay, and immunoperoxidase staining.
RESULTS
The mean (SD) age of the patients with SSc was 34.8 (2.6) years. Proteinuria, positive rheumatoid factor, and C reactive protein were seen in 15.8%, 26.3%, and 26.3% of patients, respectively. Compared with HCs, there were significantly higher: total MICs (macrophages, lymphocytes), neutrophils, and eosinophils in BALF, blood, and skin (all p<0.05); cytokine concentrations in BALF (TNFalpha, p<0.001; IL-1, p<0.01) and peripheral blood (p<0.01 and p<0.05); and CD8/CD4+ T cells in peripheral blood (p<0.05). Compared with HCs, lesional skin had significantly higher histiocyte cell counts (p<0.05), lower lymphocyte counts (p<0.05), and higher CD4/CD8 ratios (p<0.001). There were significant correlations between cytokine concentrations and CD8+ T cells and forced vital capacity (p<0.001 and p<0.01, respectively).
CONCLUSIONS
MICs, CD4/CD8+ cells, and cytokines are altered in SSc. These alterations correlated with the underlying disease process and therefore may have pathogenic, modulatory, and potential prognostic roles in SSc.
背景
系统性硬化症（SSc）是一种具有潜在免疫机制的多系统疾病。
目的
研究病变的临床病理特征；支气管肺泡灌洗液（BALF）、外周血和皮肤中的免疫改变；以及SSc临床病理特征与免疫改变之间的相关性。
材料/方法：从19例系统性硬化症患者（18例女性，1例男性）和6例年龄及性别匹配的健康对照者（HCs）获取皮肤活检组织、BALF和外周血样本。使用组织学方法、酶联免疫吸附测定和免疫过氧化物酶染色检测所有样本中的单核炎性细胞（MICs）、CD4/CD8细胞、肿瘤坏死因子α（TNFα）和白细胞介素1β（IL1-1β）浓度。
结果
系统性硬化症患者的平均（标准差）年龄为34.8（2.6）岁。蛋白尿、类风湿因子阳性和C反应蛋白分别在15.8%、26.3%和26.3%的患者中出现。与健康对照者相比，BALF、血液和皮肤中的以下指标显著更高：总MICs（巨噬细胞、淋巴细胞）、中性粒细胞和嗜酸性粒细胞（均p<0.05）；BALF（TNFα，p<0.001；IL-1，p<0.01）和外周血中细胞因子浓度（p<0.01和p<0.05）；以及外周血中CD8/CD4 + T细胞（p<0.05）。与健康对照者相比，病变皮肤中的组织细胞计数显著更高（p<0.05），淋巴细胞计数更低（p<0.05），CD4/CD8比值更高（p<0.001）。细胞因子浓度与CD8 + T细胞和用力肺活量之间存在显著相关性（分别为p<0.001和p<0.01）。
结论
系统性硬化症中MICs、CD4/CD8 +细胞和细胞因子发生改变。这些改变与潜在的疾病进程相关，因此可能在系统性硬化症中具有致病、调节和潜在的预后作用。
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