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目的探讨活动期类风湿关节炎(aRA)患者趋化因子受体CCR4在外周血CD4+T细胞的表达及其意义,并对该表达与血清重要细胞因子水平的相关性进行研究。方法流式细胞计数方法对12例aRA患者和10名健康对照者外周血CD4+T细胞表面CCR4的表达情况进行检测;酶联免疫吸附试验(ELISA)方法检测患者血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-10及干扰素(IFN)-γ的水平并记录患者相关临床及实验室资料。分析及评价aRA患者外周血淋巴细胞中CD4+CCR4+T细胞百分数(CD4+CCR4+T%)与TNF-α、IL-10、IFN-γ的血清水平及临床指标的相关性。结果aRA组外周血CD4+CCR4+T%明显高于健康对照组(P<0.01)。aRA组血清TNF-α(P<0.01)、IL-10(P<0.01)及IFN-γ(P<0.01)水平明显高于健康对照组。在检测的细胞因子中,aRA患者血清IL-10水平与CD4+CCR4+T%呈明显正相关关系(r=0.66,P<0.05)。在临床指标中,CD4+CCR4+T%与aRA患者Lunsbury关节指数、血沉、C反应蛋白及血小板计数呈明显正相关关系(P<0.05)。结论CCR4在CD4+T细胞趋化至病变关节过程中可能发挥重要作用;外周血CD4+CCR4+T%与血清IL-10水平密切相关;该百分数可以作为临床评价RA活动性的一个敏感指标。
Objective To investigate the expression of chemokine receptor CCR4 in peripheral blood CD4 + T cells in patients with active rheumatoid arthritis (aRA) and to investigate its relationship with serum levels of important cytokines. Methods Flow Cytometry was used to detect the expression of CCR4 on CD4 + T cells in peripheral blood from 12 patients with aRA and 10 healthy controls. Serum tumor necrosis factor (TNF) - α, interleukin (IL) -10 and interferon (IFN) -γ levels and record the patient’s clinical and laboratory data. To analyze and evaluate the correlation between CD4 + CCR4 + T cell percentage (CD4 + CCR4 + T%) and serum levels of TNF-α, IL-10 and IFN-γ in peripheral blood lymphocytes of aRA patients and its clinical significance. Results The level of CD4 + CCR4 + T in peripheral blood of aRA group was significantly higher than that of healthy control group (P <0.01). Serum levels of TNF-α (P <0.01), IL-10 (P <0.01) and IFN-γ (P <0.01) in aRA group were significantly higher than those in healthy controls. Among the tested cytokines, the level of IL-10 in aRA patients was positively correlated with CD4 + CCR4 + T% (r = 0.66, P <0.05). In clinical indicators, there was a positive correlation between CD4 + CCR4 + T% and Lunsbury’s index, ESR, C-reactive protein and platelet count (P <0.05). Conclusions CCR4 may play an important role in the process of CD4 + T cell chemotaxis to diseased joints. The level of CD4 + CCR4 + T% in peripheral blood is closely related to the level of IL-10 in serum. This percentage may serve as a sensitive index for clinical evaluation of RA activity.