Lescoat Alain, Lecureur Valérie, Roussel Mikael, Sunnaram Béatrice Ly, Ballerie Alice, Coiffier Guillaume, Jouneau Stéphane, Fardel Olivier, Fest Thierry, Jégo Patrick
INSERM, U1085, Research Institute in Health, Environment and Occupation/Institut de Recherche en Santé, Environnement et Travail (IRSET), University of Rennes 1, Rennes, France.
Department of Internal Medicine, CHU Rennes, South Hospital, 16 bd de Bulgarie - BP 90347, 35203, Rennes Cedex 2, France.
Clin Rheumatol. 2017 Jul;36(7):1649-1654. doi: 10.1007/s10067-017-3597-6. Epub 2017 Mar 14.
The objective of this study is to assess the association of clinical manifestations of systemic sclerosis (SSc) with the absolute count of circulating blood monocyte subpopulations according to their membrane expression of CD16. Forty-eight consecutive patients fulfilling the 2013 ACR/EULAR classification criteria for SSc were included in this cross-sectional study. CD16+ monocyte absolute count was defined by flow cytometry and confronted to the clinical characteristics of SSc patients. Twenty-three healthy donors (HD) were randomly selected for comparison. SSc patients had an increased number of total circulating blood monocytes compared to HD (p < 0.001). The CD16- subpopulation absolute count was increased in SSc patients compared to HD (p < 0.001) but was similar in limited SSc (lSSc) and diffuse SSc (dSSc). On the contrary, the CD16+ population absolute count was increased in dSSc compared to both HD and lSSc patients (dSSc 0.071 Giga/L (±0.034) vs HD 0.039 Giga/L (±0.030), p < 0.01, and dSSc 0.071 Giga/L (±0.034) vs lSSc 0.048 Giga/L (±0.024), p < 0.05). The CD16+ monocyte subpopulation absolute count was significantly correlated with the severity of skin fibrosis evaluated by the modified Rodnan skin score (p < 0.001). The CD16+ monocyte subpopulation was also associated with pulmonary fibrosis (p < 0.05), with the severity of the restrictive ventilatory defect evaluated by total lung capacity (p < 0.05) and with the pulmonary function impairment reflected by diffusing capacity of the lungs for carbon monoxyde measures (p < 0.01). These results suggest that CD16+ monocytes are associated with the main fibrotic manifestations of SSc and their role in the pathogenesis of fibrosis in this autoimmune disorder should therefore be further considered.
本研究的目的是根据循环血单核细胞亚群的CD16膜表达情况，评估系统性硬化症（SSc）的临床表现与循环血单核细胞亚群绝对计数之间的关联。本横断面研究纳入了48例符合2013年美国风湿病学会（ACR）/欧洲抗风湿病联盟（EULAR）SSc分类标准的连续患者。通过流式细胞术定义CD16+单核细胞绝对计数，并将其与SSc患者的临床特征进行对比。随机选取23名健康供者（HD）作为对照。与HD相比，SSc患者循环血单核细胞总数增加（p<0.001）。与HD相比，SSc患者CD16-亚群绝对计数增加（p<0.001），但在局限性SSc（lSSc）和弥漫性SSc（dSSc）中相似。相反，与HD和lSSc患者相比，dSSc患者的CD16+群体绝对计数增加（dSSc为0.071千兆升（±0.034），HD为0.039千兆升（±0.030），p<0.01；dSSc为0.071千兆升（±0.034），lSSc为0.048千兆升（±0.024），p<0.05）。CD16+单核细胞亚群绝对计数与改良Rodnan皮肤评分评估的皮肤纤维化严重程度显著相关（p<0.001）。CD16+单核细胞亚群还与肺纤维化相关（p<0.05），与通过肺总量评估的限制性通气功能障碍严重程度相关（p<0.05），并与一氧化碳肺弥散量测量所反映的肺功能损害相关（p<0.01）。这些结果表明，CD16+单核细胞与SSc的主要纤维化表现相关，因此应进一步考虑其在这种自身免疫性疾病纤维化发病机制中的作用。
