Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Rheumatology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Int J Rheum Dis. 2024 Oct;27(10):e15324. doi: 10.1111/1756-185X.15324.
This study investigates changes in immune cell subsets in peripheral blood of ankylosing spondylitis (AS) patients with colitis or terminal ileitis. It aims to explore the connection between changes in lymphocyte subsets and gut inflammation, providing insights for early detection.
Overall, 50 AS patients undergoing colonoscopy were enrolled. Flow cytometry was employed to analyze lymphocyte subsets, including T and B cells, in peripheral blood. Disease activity was assessed using CRP, ESR, BASDAI, ASDAS-CRP, and ASDAS-ESR.
Compared to AS patients without gut inflammation, those with colorectal inflammation showed a significant increase in total T cells (p < .05), an increase in exhausted CD4 T cells (p < .05), and a decrease in Th2 cells and total Tc cells (p < .05). Notably, in AS patients with terminal ileitis, there was an increase in total B cells and classic switched B cells (p < .05), with a decrease in double-positive T cells (p < .05). However, no significant differences were observed in the distribution of Tfh-cell subpopulations (Tfh1, Tfh2, Tfh17) and Tc-cell subpopulations (Tc1, Tc2, Tc17) between AS patients with either colorectal inflammation or terminal ileitis (p > .05). We explored the relationship between disease activity scores, ESR, CRP, and lymphocyte subsets, but found no statistically significant correlation between them.
Distinct immune patterns may exist in AS with different types of intestinal inflammation. Colitis in AS is primarily characterized by a significant increase in exhausted CD4 T cells, along with a decrease in Th2 cells. In contrast, terminal ileum inflammation in AS is marked by an increase in total B cells and classic switched B cells. These findings offer new insights for early detection and therapeutic intervention.
本研究旨在探讨伴有结直肠炎或末端回肠炎的强直性脊柱炎（AS）患者外周血免疫细胞亚群的变化，探索淋巴细胞亚群变化与肠道炎症的关系，为早期检测提供依据。
共纳入 50 例行结肠镜检查的 AS 患者，采用流式细胞术分析外周血淋巴细胞亚群，包括 T 细胞和 B 细胞。采用 CRP、ESR、BASDAI、ASDAS-CRP 和 ASDAS-ESR 评估疾病活动度。
与无肠道炎症的 AS 患者相比，结直肠炎患者总 T 细胞显著增加（p<0.05），耗竭型 CD4 T 细胞增加（p<0.05），Th2 细胞和总 Tc 细胞减少（p<0.05）。值得注意的是，末端回肠炎患者总 B 细胞和经典转换 B 细胞增加（p<0.05），双阳性 T 细胞减少（p<0.05）。然而，结直肠炎和末端回肠炎患者的 Tfh 细胞亚群（Tfh1、Tfh2、Tfh17）和 Tc 细胞亚群（Tc1、Tc2、Tc17）分布无显著差异（p>0.05）。我们探讨了疾病活动评分、ESR、CRP 与淋巴细胞亚群之间的关系，但未发现它们之间存在统计学相关性。
不同类型肠道炎症的 AS 可能存在不同的免疫模式。AS 结肠炎主要表现为耗竭型 CD4 T 细胞显著增加，Th2 细胞减少。相反，AS 末端回肠炎以总 B 细胞和经典转换 B 细胞增加为特征。这些发现为早期检测和治疗干预提供了新的思路。
