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[系统性轻链淀粉样变性患者的T细胞免疫谱分析]

[T cell immune profiling of systemic light chain amyloidosis patients].

作者信息

Xu L S, Liu Y, Duan W B, Wen L, Wang Y C, Ge Q, Lu J

机构信息

Department of Immunology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China.

Peking University People's Hospital, Paking University Institute of Hematology, Beijing 100044, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2020 Apr 14;41(4):313-317. doi: 10.3760/cma.j.issn.0253-2727.2020.04.010.

Abstract

To investigate the characteristics of T cell immunophenotype and its relationship with clinical manifestation in patients with systemic light chain amyloidosis (AL) . The peripheral blood mononuclear cells from 36 patients with AL were collected and analyzed by multicolor flow cytometry, and the expression of surface antigen CD3, CD56, CD4, CD8, CD25, CD45RA, CD28, CD57 and nuclear antigen FOXP3 were examined. Samples from 28 age-matched healthy donors (HD) were also examined. Patients were divided by Mayo 2012 staging system and the difference between immunophenotype of Ⅰ-Ⅱ and Ⅲ-Ⅳ stage patients were analyzed. The correlations between the proportion of T-cell subpopulation and clinical manifestations in λ light chain type AL patients were analyzed. The differences in the peripheral total T cells and T cell subsets, including CD4(+), CD8(+), regulatory T cells, and natural killer T cells were not significantly between AL and HD. The ratio of CD57(+) cells in CD8(+) T cells was lower in AL than in HD, and there was no significantly difference in the rate of CD45RA(+) and CD28(+)cells between these two groups. No differences were found in the ratio of total T cells or T cell subsets between stages Ⅰ-Ⅱ and Ⅲ-Ⅳaccording to the standard of Mayo 2012. Within λ light chain type AL patients, peripheral CD8(+) T cell ratio was positively correlated with 24-hour urine protein and creatinine level and negatively correlated with estimated glomerular filtration rate (eGFR) . The overall T cell distribution in the periphery is not significantly different between AL patients and age-matched healthy donors. However, the percentages of CD8(+) T cells are positively correlated with renal injury, indicating the importance of CD8(+) T cell subset in the prognostic evaluation of renal involvement.

摘要

探讨系统性轻链型淀粉样变性(AL)患者T细胞免疫表型特征及其与临床表现的关系。收集36例AL患者的外周血单个核细胞,采用多色流式细胞术进行分析,检测表面抗原CD3、CD56、CD4、CD8、CD25、CD45RA、CD28、CD57及核抗原FOXP3的表达。同时检测28例年龄匹配的健康供者(HD)的样本。根据Mayo 2012分期系统对患者进行分组,分析Ⅰ-Ⅱ期和Ⅲ-Ⅳ期患者免疫表型的差异。分析λ轻链型AL患者T细胞亚群比例与临床表现的相关性。AL患者与HD患者外周血总T细胞及T细胞亚群(包括CD4(+)、CD8(+)、调节性T细胞和自然杀伤T细胞)的差异无统计学意义。AL患者CD8(+) T细胞中CD57(+)细胞的比例低于HD患者,两组间CD45RA(+)和CD28(+)细胞的比例差异无统计学意义。根据Mayo 2012标准,Ⅰ-Ⅱ期和Ⅲ-Ⅳ期患者的总T细胞或T细胞亚群比例无差异。在λ轻链型AL患者中,外周血CD8(+) T细胞比例与24小时尿蛋白及肌酐水平呈正相关,与估计肾小球滤过率(eGFR)呈负相关。AL患者外周血T细胞总体分布与年龄匹配的健康供者无明显差异。然而,CD8(+) T细胞百分比与肾损伤呈正相关,提示CD8(+) T细胞亚群在肾脏受累预后评估中的重要性。

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