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目的探讨类风湿关节炎(RA)T淋巴细胞上淋巴细胞激活诱导的受体4-1BB的表达及其作用机制。方法应用流式细胞术检测30例RA患者和20名正常对照者外周血T细胞活化前后4-1BB的表达。结果RA患者CD4~+T和CD8~+T细胞表达的4-1BB明显高于正常对照组[表达百分率分别为(18．56±4．08)％,(10．33±2．13)％,(1．24±0．12)％,(0．87±0．09)％,P＜0．01],经抗CD3单抗体外刺激后CD4~+T和CD8~+T细胞表达的4-1BB均显著高于活化前[表达百分率为(33±4)％和(21±8)％,P＜0．01]。RA患者CD4~+T/CD8~+T比值明显升高,而且与4-1BB~+CD4~+T细胞数呈正相关关系(r=0．84,P＜0.01),另外4-1BB~+CD4~+T细胞数与血沉、IgA呈正相关关系(r=0．476,P＜0．05；r=0．659,P＜0．05)。结论RA患者T细胞表达的4-IBB在RA的发生发展中具有重要意义,4-1BB可能通过对CD4~+T活化与增殖参与关节炎症和免疫反应。
Objective To investigate the expression of receptor 4-1BB induced by lymphocyte activation on rheumatoid arthritis (RA) T lymphocytes and its mechanism. Methods Flow cytometry was used to detect the expression of 4-1BB in peripheral blood of 30 patients with RA and 20 normal controls before and after T cell activation. Results The expression of 4-1BB in CD4 ~ + T and CD8 ~ + T cells in RA patients was significantly higher than that in the normal control group [(18.56 ± 4.08)%, (10.33 ± 2.13)%, , (1.24 ± 0.12)%, (0.87 ± 0.09)% respectively, P <0.01]. The levels of CD4 ~ + T and CD8 ~ + T cells stimulated by anti-CD3 monoclonal antibody 4-1BB were significantly higher than those before activation [expression percentage (33 ± 4)% and (21 ± 8)%, P <0.01]. The ratio of CD4 ~ + T / CD8 ~ + T in patients with RA was significantly higher than that in patients with RA (r = 0.84, P <0.01) The number of CD4 ~ + T cells was positively correlated with ESR and IgA (r = 0.476, P <0.05; r = 0.659, P <0.05). Conclusions 4-IBB expressed in T cells of RA patients is of great significance in the development of RA. 4-1BB may participate in joint inflammation and immune response through activation and proliferation of CD4 + T cells.