Murray K J, Luyrink L, Grom A A, Passo M H, Emery H, Witte D, Glass D N
William S. Rowe Division of Rheumatology, Department of Pediatrics, Children's Hospital Medical Center, University of Cincinnati, College of Medicine, OH, USA.
J Rheumatol. 1996 Dec;23(12):2116-24.
To characterize synovial T cell infiltrate, in terms of CD4/CD8 ratio and level of activation of T cells, in juvenile rheumatoid arthritis (JRA) and juvenile spondyloarthropathy(JSpA), to correlate these findings with clinical outcomes of the different forms of disease, and to compare them with findings in adult RA synovium.
We studied synovial tissue specimens from 22 individuals with childhood onset of chronic arthritis (12 polyarticular JRA, 5 pauciarticular JRA, 5 JSpA) and 4 with adult RA. Specimens were selected from an initial bank from 40 patients on the basis of significant inflammation on hematoxylin and eosin and CD3 and CD68 monoclonal antibody staining (T cells and macrophages, respectively). Indirect immunohistochemistry was used with monoclonal antibodies to CD3, CD4, CD8, and interleukin 2 receptor alpha to determine CD4/CD8 ratios and the levels of activation within the T cell subsets. The distribution of gamma delta T cells was also studied.
Two patterns of T cell infiltration were seen. The majority of patients had lymphocytic aggregates associated with diffuse infiltrates; a few tissue specimens had diffuse infiltrates without aggregates. The CD4/CD8 ratio was significantly lower in pauciarticular course JRA than polyarticular JRA (p < 0.01) and RA (p < 0.05). Similarly patients with JSpA had a significantly lower CD4/CD8 ratio than patients with polyarticular JRA (P < 0.05). The level of T cell activation (CD3+IL-2R+) was significantly higher in pauciarticular compared with both polyarticular JRA (P < 0.01) and RA (p < 0.05). In general, higher levels of activation of CD8 cells than CD4 cells were seen, particularly in the pauciarticular JRA and JSpA groups. gamma delta T cells were prominent in 2 patients.
Demonstrated differences in T cell subset distribution between types of childhood chronic arthritis at a histopathological level may reflect different pathogenic mechanisms.
根据CD4/CD8比值和T细胞活化水平，对幼年类风湿关节炎（JRA）和幼年脊柱关节炎（JSpA）患者的滑膜T细胞浸润情况进行特征分析，将这些结果与不同疾病形式的临床结局相关联，并与成人类风湿关节炎（RA）滑膜的研究结果进行比较。
我们研究了22例儿童期起病的慢性关节炎患者（12例多关节型JRA、5例少关节型JRA、5例JSpA）和4例成人RA患者的滑膜组织标本。这些标本是从最初的40例患者样本库中选取的，选取依据是苏木精-伊红染色以及CD3和CD68单克隆抗体染色（分别针对T细胞和巨噬细胞）显示有明显炎症。采用间接免疫组织化学方法，使用针对CD3、CD4、CD8和白细胞介素2受体α的单克隆抗体来确定CD4/CD8比值以及T细胞亚群内的活化水平。同时也研究了γδT细胞的分布情况。
观察到两种T细胞浸润模式。大多数患者有与弥漫性浸润相关的淋巴细胞聚集；少数组织标本有无聚集的弥漫性浸润。少关节型病程的JRA患者的CD4/CD8比值显著低于多关节型JRA（p<0.01）和RA（p<0.05）。同样，JSpA患者的CD4/CD8比值显著低于多关节型JRA患者（P<0.05）。与多关节型JRA（P<0.01）和RA（p<0.05）相比，少关节型患者的T细胞活化水平（CD3+IL-2R+）显著更高。总体而言，观察到CD8细胞的活化水平高于CD4细胞，尤其是在少关节型JRA和JSpA组。2例患者中γδT细胞较为突出。
在组织病理学水平上，儿童慢性关节炎不同类型之间T细胞亚群分布的差异可能反映了不同的致病机制。
