Torsteinsdóttir I, Arvidson N G, Hällgren R, Håkansson L
Department of Clinical Chemistry, University Hospital, Uppsala, Sweden.
Clin Exp Immunol. 1999 Mar;115(3):554-60. doi: 10.1046/j.1365-2249.1999.00817.x.
The aim of this work was to study the expression of beta 1- and beta 2-integrins, CR1, CD44 and Fc gamma receptors on peripheral blood monocytes in RA. The expression of these receptors was measured by flow cytometry, before and after treatment with low-dose prednisolone. Expression of the same receptors was also measured before and after treatment with metyrapone, a substance that inhibits the synthesis of cortisol in the adrenals. The expression of the beta 2-integrins CD11a, CD11b and CD18, of CD35 (CR1), and of Fc gamma RII and Fc gamma RI (CD32 and CD64) on monocytes was elevated in the RA patients compared with healthy controls, while the expression of the beta 1-integrins (CD29, CD49d, CD49f) was unaffected. A significant correlation between monocyte expression of CD64 and C-reactive protein (CRP), and blood platelet count, respectively, was found in the group of patients with RA. After 4-6 weeks of treatment with low-dose prednisolone, the expression on the monocytes of CD11a, CD11b, CD18, CD35, CD32 and CD64 was normalized. A significant correlation (r = 0.64, P = 0.02) was found between the decrease in expression of CD11b and clinical improvement after prednisolone treatment. Two days of metyrapone treatment, which significantly lowered the serum cortisol levels, elevated the expression of CD35 and CD49f. Priming of peripheral monocytes seems to be one of the mechanisms behind the recruitment of monocytes to the rheumatoid synovium. One reason for the good clinical effects of prednisolone in RA could be a down-regulation of adhesion and phagocytosis receptors on monocytes.
这项研究的目的是研究类风湿关节炎（RA）患者外周血单核细胞上β1-和β2-整合素、补体受体1（CR1）、CD44和Fcγ受体的表达情况。在用低剂量泼尼松龙治疗前后，通过流式细胞术测定这些受体的表达。还测定了用甲吡酮（一种抑制肾上腺皮质醇合成的物质）治疗前后相同受体的表达。与健康对照相比，RA患者单核细胞上β2-整合素CD11a、CD11b和CD18、CD35（CR1）以及FcγRII和FcγRI（CD32和CD64）的表达升高，而β1-整合素（CD29、CD49d、CD49f）的表达未受影响。在RA患者组中，分别发现单核细胞CD64表达与C反应蛋白（CRP）以及血小板计数之间存在显著相关性。用低剂量泼尼松龙治疗4 - 6周后，单核细胞上CD11a、CD11b、CD18、CD35、CD32和CD64的表达恢复正常。泼尼松龙治疗后，CD11b表达的降低与临床改善之间存在显著相关性（r = 0.64，P = 0.02）。两天的甲吡酮治疗显著降低了血清皮质醇水平，同时升高了CD35和CD49f的表达。外周单核细胞的预激活似乎是单核细胞募集到类风湿滑膜的机制之一。泼尼松龙在RA中产生良好临床效果的一个原因可能是单核细胞上黏附及吞噬受体的下调。
