Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Department of Neurology, The First People's Hospital of Nanning, Nanning 530000, China.
Clin Immunol. 2019 Aug;205:130-137. doi: 10.1016/j.clim.2018.10.012. Epub 2018 Oct 22.
Although it is well documented that circulating dendritic cells (DCs) have specialized features during many kinds of physiological and pathological conditions, there are few reports about the features of DCs in the peripheral blood of myasthenia gravis (MG) patients. We investigated the quantitative and component features of DCs and their implications in MG. Peripheral blood samples from different kinds of MG patients were collected and their clinical characteristics were recorded. Using flow cytometry, we distinguished circulating DC subsets [plasmacytoid DCs (pDCs) and myeloid DCs (mDCs)] and enumerated their densities in peripheral blood. Absolute numbers of circulating pDCs were significantly decreased in naïve MG patients compared with healthy controls, resulting in a markedly lower ratio of the pDC to mDC percentage in total circulating DCs (pDCs/mDCs), suggesting an imbalance in the proportions of the two main circulating DC subsets. The clinical status of MG patients was improved after drug treatment, together with increased pDCs/mDCs. In a longitudinal follow-up, we observed that circulating mDCs were significantly reduced after 1 month of therapy with a corticosteroid and immunosuppressant, resulting in recovery of pDCs/mDCs. Although the exact meaning of the proportion change in circulating DC subsets is unknown, pDCs/mDCs might reflect the balance between the autoimmune response and immune tolerance of a patient. Moreover, changes in pDCs/mDCs during treatment might be a promising marker to predict the efficacy of a specific drug used for MG patients.
虽然有大量文献记载，在许多生理和病理条件下，循环树突状细胞（DCs）具有特殊的特征，但关于重症肌无力（MG）患者外周血 DCs 特征的报道较少。我们研究了 DCs 的定量和成分特征及其在 MG 中的意义。收集了不同类型 MG 患者的外周血样本，并记录了其临床特征。我们使用流式细胞术区分循环 DC 亚群（浆细胞样 DCs [pDCs] 和髓样 DCs [mDCs]）并计数其在外周血中的密度。与健康对照组相比，初发 MG 患者外周血中循环 pDCs 的绝对数明显减少，导致总循环 DC 中 pDC 与 mDC 百分比的比值显著降低（pDCs/mDCs），表明两种主要循环 DC 亚群的比例失衡。MG 患者的临床状况在药物治疗后得到改善，同时 pDCs/mDCs 增加。在纵向随访中，我们观察到在接受皮质类固醇和免疫抑制剂治疗 1 个月后，循环 mDCs 明显减少，导致 pDCs/mDCs 恢复。虽然循环 DC 亚群比例变化的确切意义尚不清楚，但 pDCs/mDCs 可能反映了患者自身免疫反应和免疫耐受之间的平衡。此外，治疗过程中 pDCs/mDCs 的变化可能是预测 MG 患者特定药物疗效的有前途的标志物。
