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目的探讨原发性干燥综合征(primary Sjgren’s syndrome,pSS)患者外周血单个核细胞(PBMC)表面P2X7受体表达情况及其与焦虑、抑郁的相关性。方法用汉密尔顿焦虑、抑郁量表对31例pSS患者(pSS组)进行心理评估,分离其PBMC,在有或无ATP刺激后用流式细胞术检测CD14+PBMC及CD14-PBMC表面P2X7受体的表达水平,并用酶联免疫吸附试验测定ATP刺激前后白介素(interleukin,IL)-1β、IL-6水平。另外,分别设有19例类风湿关节炎(rheumatoid arthritis,RA)患者(RA组)及18例单纯焦虑、抑郁障碍患者(焦虑抑郁组)作为阳性对照,20例健康人(健康组)为阴性对照。结果所有4组受试者PBMC表面均有P2X7受体表达。ATP刺激较未刺激,CD14+PBMC(单核细胞)表面P2X7受体表达仅在pSS组[(5.6%3±2.48%)vs.(3.98%±1.68%),t=3.647,P=0.001]显著增高,而在CD14-PBMC(主要为淋巴细胞)表面其表达在pSS组[(16.92%±9.25%)vs.(10.06%±4.35%),t=4.908,P<0.001]及焦虑抑郁组[(12.68%±8.15%)vs.(8.07%±5.05%),t=3.412,P=0.003]均显著增高。ATP刺激后,pSS组CD14+PBMC表面P2X7受体表达显著高于RA组[(5.63%±2.48%)vs.(4.15%±2.20%),P=0.044]、焦虑、抑郁组[(5.63%±2.48%)vs.(3.35%±1.80%),P=0.004]及健康组[(5.63%±2.48%)vs.(3.25%±2.05%),P=0.002]。ATP刺激后,pSS患者PBMC上清中IL-1β水平与刺激后外周血CD14+PBMC表面P2X7受体表达呈显著正相关(r=0.447,P=0.025)。pSS组存在焦虑的患者占45.2%(1431),存在抑郁的患者占32.3%(1031)。ATP刺激后,CD14-PBMC表面P2X7受体表达与pSS组、焦虑抑郁组焦虑评分(r=0.344,P=0.030)及抑郁评分(r=0.319,P=0.045)呈显著正相关。结论 pSS患者PBMC表面P2X7受体高表达,可能与pSS的发病机制及其合并焦虑、抑郁相关。
Objective To investigate the expression of P2X7 receptor on peripheral blood mononuclear cells (PBMC) in patients with primary Sjögren’s syndrome (pSS) and its relationship with anxiety and depression. Methods Thirty-one patients with pSS (pSS group) were assessed by psychology using the Hamilton Anxiety and Depression Scale, and their PBMCs were isolated. Flow cytometry was used to detect the expression of P2X7 receptor on CD14 + PBMCs and CD14-PBMCs with or without ATP stimulation The level of interleukin (IL) -1β and IL-6 before and after ATP stimulation were measured by enzyme linked immunosorbent assay. In addition, 19 patients with rheumatoid arthritis (RA) and 18 patients with anxiety and depression (anxiety and depression) groups were selected as positive control and 20 healthy people (healthy group) as negative control Control. Results All 4 groups of subjects had P2X7 receptor expression on the PBMC surface. P2X7 receptor expression on CD14 + PBMC (mononuclear cells) was only in the pSS group [(5.6% 3 ± 2.48%) vs. (3.98% ± 1.68%), t = 3.647, P = 0.001] (16.92% ± 9.25%) vs. (10.06% ± 4.35%), t = 4.908, P <0.001] and anxiety depression group on the surface of CD14-PBMCs (mainly lymphocytes) [(12.68% ± 8.15%) vs. (8.07% ± 5.05%), t = 3.412, P = 0.003]. After ATP stimulation, the expression of P2X7 receptor on CD14 + PBMC in pSS group was significantly higher than that in RA group (5.63% ± 2.48% vs. 4.15% ± 2.20%, P = 0.044), anxiety and depression group (5.63% ± 2.48% vs. 3.35% ± 1.80%, P = 0.004], and healthy group (5.63% ± 2.48% vs. 3.25% ± 2.05%, P = 0.002). After ATP stimulation, the level of IL-1β in PBMC supernatant of pSS patients was positively correlated with the expression of P2X7 receptor on the surface of CD14 + PBMCs after stimulation (r = 0.447, P = 0.025). 45.2% (1431) of patients with anxiety in the pSS group and 32.3% (1031) of patients with depression. After ATP stimulation, the expression of P2X7 on CD14-PBMC surface was positively correlated with anxiety score (r = 0.344, P = 0.030) and depression score (r = 0.319, P = 0.045) in pSS group and anxiety depression group. Conclusion The high expression of P2X7 receptor on PBMC in patients with pSS may be related to the pathogenesis of pSS and its associated anxiety and depression.