Dauphinée M, Tovar Z, Talal N
Clinical Immunology Section, Audie L. Murphy Memorial Veterans Hospital, San Antonio, Texas.
Arthritis Rheum. 1988 May;31(5):642-7. doi: 10.1002/art.1780310509.
In this investigation of B cells expressing the CD5 (Leu-1) cell surface marker, we found increased numbers of these cells in 13 of 19 patients with primary Sjögren's syndrome (SS) (68%), as well as in the rheumatoid arthritis patients. The percentage of B cells that demonstrated increased expression of CD5 was 46% in SS patients, 47% in rheumatoid arthritis patients, 24% in systemic lupus erythematosus patients, and 26% in normal subjects. Over a 2-year period, CD5 expression on B cells was a stable finding in several patients, except for 2 who required either steroid therapy or combined chemotherapy and irradiation for malignant lymphoma. Both of these patients had clinical remissions and their levels of CD5+ B cells returned to normal. The first patient had a clinical picture of SS/systemic lupus erythematosus overlap, associated with polyclonal B cell activation and decreased production of interleukin-2 in response to stimulation with phytohemagglutinin. These cellular immune abnormalities returned to normal after the institution of corticosteroids. Our observations suggest a relationship between the CD5+ B cell abnormality and disease activity. The results are discussed in relation to immunoregulatory properties of CD5+ B cells in autoimmune mice and the characteristic predisposition to malignant lymphoma among SS patients.
在这项对表达CD5（Leu-1）细胞表面标志物的B细胞的研究中，我们发现19例原发性干燥综合征（SS）患者中有13例（68%）以及类风湿关节炎患者体内这些细胞数量增加。在SS患者中，CD5表达增加的B细胞百分比为46%，类风湿关节炎患者中为47%，系统性红斑狼疮患者中为24%，正常受试者中为26%。在两年时间里，除了2例因恶性淋巴瘤需要接受类固醇治疗或联合化疗及放疗的患者外，B细胞上的CD5表达在数名患者中是一个稳定的发现。这两名患者临床症状均缓解，其CD5+B细胞水平恢复正常。首例患者有SS/系统性红斑狼疮重叠的临床表现，伴有多克隆B细胞活化以及对植物血凝素刺激反应时白细胞介素-2产生减少。使用皮质类固醇后，这些细胞免疫异常恢复正常。我们的观察结果提示CD5+B细胞异常与疾病活动之间存在关联。结合自身免疫小鼠中CD5+B细胞的免疫调节特性以及SS患者发生恶性淋巴瘤的特征性易感性对结果进行了讨论。
