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莱姆病患者外周血淋巴细胞亚群与伯氏疏螺旋体抗体的相关性分析。

Analysis of some peripheral blood lymphocyte subsets in relation to Borrelia burgdorferi antibodies in patients with Lyme disease.

作者信息

Zajkowska J M, Hermanowska-Szpakowicz T, Wysocka J, Kondrusik M, Pancewicz S A, Grygorczuk S

机构信息

Department of Infectious Diseases and Neuroinfections, Medical Academy of Białystok.

出版信息

Rocz Akad Med Bialymst. 2000;45:184-98.

Abstract

The aim of our study was to evaluate the changes in T (CD3), B(CD19) lymphocytes, CD4 and CD8 subsets, activated CD3+ HLA-DR+ lymphocytes, lymphocytes with receptor for IL-2 (CD3+CD25), NK cells as well as the rate of CD4/CD8 in 30 patients with recognized Lyme disease, before and after antibiotic therapy. Patients were divided into the following groups: Group I n = 9--without detected specific antibodies against B. burgdorferi and with clinical recognition of EM(erythema migrans). Group II n = 10--with increased IgM production, with a clinical form of Lyme arthritis and neuroborreliosis. Group III n = 11--with increased IgG anti B. burgdorferi production, with clinical recognition of Lyme arthritis. The results were compared with the results obtained in the control group consisting of 90 healthy people. The measurements were performed in the flow cytometer COULTER EPI XL with Becton Dickinson antibodies. The antibodies against B. burgdorferi were detected by means of ELISA method using Dako, Biomedica and Biocom kits. The statistic analysis was performed with AnStat Program. The changes in lymphocyte subsets were characterised by the decrease in the percentage of CD4, CD8, NK and CD3+HLA-DR+ lymphocytes in peripheral blood before treatment with later tendency to increase. The results show that the lag phase of antibodies production coincides with high activity of lymphocytes (group I). The significant level of antibodies in IgM class induced by the collaboration of T and B cells was found in the group II. In the group III, in which antibodies in IgG class predominated, the changes in lymphocyte subsets were less intensive. The results of our investigations indicate that the immune response in Lyme disease develops mainly with the participation of both cellular and humoral response which is involved in both the defense against and the pathogenesis of the disease.

摘要

我们研究的目的是评估30例确诊莱姆病患者在抗生素治疗前后T(CD3)、B(CD19)淋巴细胞、CD4和CD8亚群、活化的CD3 + HLA - DR +淋巴细胞、具有IL - 2受体的淋巴细胞(CD3 + CD25)、NK细胞以及CD4/CD8比率的变化。患者被分为以下几组:第一组n = 9,未检测到抗伯氏疏螺旋体的特异性抗体,但有游走性红斑(EM)的临床诊断。第二组n = 10,IgM产生增加,临床表现为莱姆关节炎和神经型伯氏疏螺旋体病。第三组n = 11,抗伯氏疏螺旋体IgG产生增加,临床表现为莱姆关节炎。将结果与由90名健康人组成的对照组所获结果进行比较。检测在配备Becton Dickinson抗体的流式细胞仪COULTER EPI XL中进行。使用Dako、Biomedica和Biocom试剂盒通过ELISA方法检测抗伯氏疏螺旋体抗体。采用AnStat程序进行统计分析。淋巴细胞亚群的变化特征为治疗前外周血中CD4、CD8、NK和CD3 + HLA - DR +淋巴细胞百分比下降,随后有上升趋势。结果表明,抗体产生的延迟期与淋巴细胞的高活性相吻合(第一组)。在第二组中发现T细胞和B细胞协作诱导产生的IgM类抗体达到显著水平。在以IgG类抗体为主的第三组中,淋巴细胞亚群的变化程度较小。我们的研究结果表明,莱姆病中的免疫反应主要在细胞免疫和体液免疫反应的共同参与下发展,这两种免疫反应均参与了疾病的防御和发病机制。

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