Nagane Y, Utsugisawa K, Matsubara R, Yamagata M, Tohgi H
Department of Neurology, School of Medicine, Iwate Medical University, Morioka, Japan.
No To Shinkei. 1996 Jul;48(7):644-7.
We investigated the occurrence of TCR alpha beta + CD4- CD8- mononuclear cells (DN alpha beta T cells) and TCR gamma delta + CD3+ mononuclear cells (gamma delta T cells) among the peripheral blood mononuclear cells of 22 myasthenia gravis patients (MG) and 22 controls in order to examine whether extrathymic T cell subpopulations might be responsible for the pathogenesis of MG. The differences between the mean percentages of both DN alpha beta T cells and gamma delta T cells in the MG patients (DN alpha beta T cells: 0.53 +/- 0.51%, gamma delta T cells: 3.45 +/- 2.79%) and the controls (DN alpha beta T cells: 0.32 +/- 0.16%, gamma delta T cells: 3.81 +/- 2.36%) were not significantly different. However, higher DN alpha beta T cells ratios (1.48 approximately 1.84%) were noted in three MG patients. Thymectomy and subsequent thorough dissection of the anterior mediastinum 3 years after thymectomy had no effect on the symptoms of one patient, a 25-year-old woman without thymoma. The other two patients, a 45-year-old man and a 41-year-old woman without thymoma, had recurrences despite long-term remissions (14 years and 30 years, respectively) after thymectomy. Examination of DN alpha beta T cells, which are probably generated extrathymically without negative selection, may play an important role in understanding the pathogenesis in these three cases of MG.
我们调查了22例重症肌无力患者（MG）和22例对照者外周血单个核细胞中TCRαβ⁺CD4⁻CD8⁻单个核细胞（双阴性αβT细胞）和TCRγδ⁺CD3⁺单个核细胞（γδT细胞）的发生情况，以检查胸腺外T细胞亚群是否可能与MG的发病机制有关。MG患者（双阴性αβT细胞：0.53±0.51%，γδT细胞：3.45±2.79%）和对照者（双阴性αβT细胞：0.32±0.16%，γδT细胞：3.81±2.36%）中双阴性αβT细胞和γδT细胞的平均百分比差异无统计学意义。然而，在3例MG患者中观察到较高的双阴性αβT细胞比例（1.48%至1.84%）。胸腺切除及胸腺切除3年后对前纵隔进行彻底解剖对1例患者（1名25岁无胸腺瘤的女性）的症状无影响。另外2例患者（1名45岁男性和1名41岁无胸腺瘤的女性）在胸腺切除术后尽管有长期缓解（分别为14年和30年）仍复发。对可能在胸腺外产生且无阴性选择的双阴性αβT细胞进行检测，可能在理解这3例MG病例的发病机制中起重要作用。
