Lin Zhiming, Lin Qu, Liao Zetao, Li Qiuxia, Zhang Fucheng, Wei Qiujing, Cao Shuangyan, Gu Jieruo
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People's Republic of China.
Inflammation. 2014 Dec;37(6):2056-61. doi: 10.1007/s10753-014-9938-6.
The objective of this study was to evaluate which subtypes of T lymphocytes (CD3(+)CD28(+) and CD3(+)CD154(+)) could predict clinical efficacy after TNF-α inhibitor treatment in active axial SpA patients. Patients who fulfilled Assessment of SpondyloArthritis international Society (ASAS) criteria for axial SpA had a BASDAI of ≥40 mm. All patients received TNF-α inhibitor treatment for 12 weeks. ASAS20 was used to evaluate the effect of the treatment at week 12. We detected the percentage of CD3(+)CD28(+) and CD3(+)CD154(+) T lymphocytes on lymphocyte cells in the peripheral blood in patients and healthy controls. We evaluated whether the percentage of the above subtypes of T lymphocytes could predict clinical efficacy by ROC curve analysis. Fifty-eight healthy controls and 74 active axial SpA patients were included. Mean age was 26.28 ± 9.08 and 26.95 ± 8.13 years for healthy controls and patients, respectively (p = 0.767). The percentage of CD3(+)CD154(+) T lymphocytes was significantly higher in axial SpA patients than in healthy controls (1.62 ± 1.89 % vs 0.79 ± 0.52 %, p < 0.0005). At baseline, the percentage of CD3(+)CD154(+) T lymphocytes was significantly higher in HLA-B27((+)) patients than HLA-B27((-)) ones (HLA-B27(+) vs HLA-B27(-):1.77 ± 1.95 % vs 0.41 ± 0.27 %, p = 0.005). Compared with baseline, the percentage of CD3(+)CD154(+) T lymphocytes significantly decreased to 0.87 ± 0.49 % at week 12 (p < 0.0005). Moreover, we found higher percentage of CD3(+)CD154(+) T lymphocytes could predict clinical efficacy of SpA patients with TNF-α inhibitor treatment (AUC = 0.733, p = 0.014). High percentage of CD3(+)CD154(+) is over-expressed on lymphocytes in peripheral blood of active SpA patients and can be down-regulated by TNF-α inhibitor therapy. High-percentage of CD3(+)CD154(+) T lymphocytes may predict clinical efficacy of TNF-α inhibitor treatment in active axial SpA patients.
本研究的目的是评估哪种T淋巴细胞亚型（CD3(+)CD28(+)和CD3(+)CD154(+)）能够预测肿瘤坏死因子-α（TNF-α）抑制剂治疗对活动性中轴型脊柱关节炎（SpA）患者的临床疗效。符合国际脊柱关节炎协会（ASAS）中轴型SpA标准的患者，其巴斯强直性脊柱炎疾病活动指数（BASDAI）≥40 mm。所有患者接受TNF-α抑制剂治疗12周。采用ASAS20评估第12周时的治疗效果。我们检测了患者和健康对照外周血淋巴细胞中CD3(+)CD28(+)和CD3(+)CD154(+) T淋巴细胞的百分比。通过ROC曲线分析评估上述T淋巴细胞亚型的百分比是否能够预测临床疗效。纳入了58名健康对照和74名活动性中轴型SpA患者。健康对照和患者的平均年龄分别为26.28±9.08岁和26.95±8.13岁（p = 0.767）。中轴型SpA患者中CD3(+)CD154(+) T淋巴细胞的百分比显著高于健康对照（1.62±1.89% vs 0.79±0.52%，p < 0.0005）。在基线时，人类白细胞抗原B27（HLA-B27）阳性患者中CD3(+)CD154(+) T淋巴细胞的百分比显著高于HLA-B27阴性患者（HLA-B27阳性 vs HLA-B27阴性：1.77±1.95% vs 0.41±0.27%，p = 0.005）。与基线相比，第12周时CD3(+)CD154(+) T淋巴细胞的百分比显著降至0.87±0.49%（p < 0.0005）。此外，我们发现较高百分比的CD3(+)CD154(+) T淋巴细胞能够预测SpA患者接受TNF-α抑制剂治疗的临床疗效（曲线下面积[AUC]=0.733，p = 0.014）。高百分比的CD3(+)CD154(+)在活动性SpA患者外周血淋巴细胞上过度表达，并且可被TNF-α抑制剂治疗下调。高百分比的CD3(+)CD154(+) T淋巴细胞可能预测TNF-α抑制剂治疗对活动性中轴型SpA患者的临床疗效。
