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系统性红斑狼疮患者糖皮质激素联合免疫抑制剂治疗前后外
周血NK细胞和受体表达变化及其治疗作用机制

冯 莉,赵 令,马 宁,姜振宇   

  1. 吉林大学第一医院风湿科，吉林 长春 130021
  • 收稿日期:2013-08-13 出版日期:2014-01-28 发布日期:2014-01-25
  • 通讯作者: 姜振宇 (Tel：0431-88782060，E-mail: jlujzy@aliyun.com) E-mail:jlujzy@aliyun.com
  • 作者简介:冯 莉（1988-），女，黑龙江省双鸭山市人，医师，在读医学硕士，主要从 事系统性红斑狼疮基础与临床研究。
  • 基金资助:

     吉林省长春市科技局科研基金资助课题（201212）

Changes of NK cells and its receptors expressions in  peripheral blood of patients with systematic lupus  erythematosus before and after treatment of  glucocorticoid combined with immunodepressant

FENG Li,ZHAO Ling,MA Ning,JIANG Zhen-yu   

  1.  Department of Rheumatology,First Hospital,Jilin University,Changchun 130021,China
  • Received:2013-08-13 Online:2014-01-28 Published:2014-01-25

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摘要：

目的:探讨经糖皮质激素联合免疫抑制剂干扰素γ（IFN-γ）治疗前后系统性红斑狼疮（SLE）患者外周血中自然杀伤细胞（CD3－CD56+NK细胞）及其
激活性、抑制性受体表达的变化，阐明其治疗SLE的作用机制。方法：选取26例SLE患者和16例健康对照者，采用流式细胞术检测2组受试者治疗前、治疗4和12周后外周血CD3－CD56+NK细胞比率及其激活性受体和抑制性受体表达率。结果：与健康对照组比较，治疗前SLE患者CD3－CD56+NK细胞比率明显降低（P<0.05），其激活性受体NKG2C+、NKP30+和NKP46+ 的表达率均明显增高（P<0.05），抑制性受体KIR2DL3+、 KIR3DL1+和NKG2A+的表达率均明
显降低（P<0.05），IFN-γ+ CD3－CD56+NK细胞比率明显增高（P<0.001）。与治疗前比较，治疗4和12周后SLE患者CD3－CD56+NK细胞比率均明显增高（P<0.05）；治疗4周后SLE患者CD3－CD56+NK细胞激活性受体NKG2C+、NKP30+和NKP46+ 的表达率均明显降低（P<0.05），治疗12周后上述受体表达率均进一步降低（P<0.05）。治疗4周后SLE患者CD3－CD56+NK细胞抑制性受体KIR2DL3+、KIR3DL1+和NKG2A+的表达率较治疗前均明显增高（P<
0.05），治疗12周后CD3－CD56+NK细胞 KIR3DL1+、CD158a+、CD158b+和NKG2A+的表达率较治疗前均明显增高（P<0.05）。与治疗前比较，治疗4和12周后SLE患者IFN-γ+CD3－CD56+NK　细胞比率均明显降低（P<0.001）。结论：NK细胞及其受体的变化可能与SLE的发病有关，糖皮质激素联合免疫抑制剂可能通过调节NK细胞及其受体的变化发挥治疗作用。


关键词: 系统性红斑狼疮, 自然杀伤细胞, 干扰素&gamma

Abstract:

Objective To explore the changes of NK cells and  the expression levels of their activated and inhibitory receptors in peripheral blood of the patients
with systematic lupus erythematosus (SLE) before and after treatment of glucocorticoid combined with immunodepressant,and to clarify its action mechanism on SLE.Methods 26 patients with new onset SLE and 16 healthy controls were selected.The expression levels  of NK cells,their activated and inhibitory receptors i
n peripheral blood in two groups were detected before treatment, 4 and 12 weeks after treatment by flow cytometry.Results  Compared with control group,the
ratio of CD3－CD56+NK cells of the patients with SLE and the expression levels of KIR2DL3+,KIR3DL1+,NKG2A+ NK in SLE patients group before treatment were significantly decreased(P<0.05);the expression levels of NKG2C+，NKP30+，NKP46+, and the ratios of IFN-γ+ NK cells were significantly increased(P<0.001).Compared with before treatment,the ratios of CD3－CD56+NK cells in the patients with SLE 4 and 12 weeks after treatment were significantly inc
reased(P<0.05）;the expression levels of NKG2C+,NKP30+, and NKP46+in the patients with SLE 4 weeks after treatment were significantly decreased(P<0.05).4 weeks after treatment,the expression  levels of KIR2DL3+,KIR3DL1+,and NKG2A+  were significantly increased compared with before treatment(P<0.05).12
weeks after treatment,the expression  levels of KIR3DL1+,CD158a+,CD158b+, and NKG2A+ were significantly increased compared with before treatment(P<0.05),and the ratios of IFN-γ+CD３－ CD56+ NK cells in the patients with SLE 4 and 12 weeks after treatment were significantly decreased compared with before treatment(P<0.001).Conclusion The changes of the NK cells and its receptors may be involved in the pathogenesis of SLE.Glucocorticoid combined with immunodepressant may play the therapeutic effect  by regulating the expression of NK cells and their receptors.

Key words: systemic lupus erythematosus, natural killer cells, interferon-&gamma

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