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目的:通过检测克罗恩病(CD)患者外周血单核细胞亚群比例及其分泌肿瘤坏死因子(TNF)-α的功能,探讨单核细胞亚群在CD发病过程中的作用。方法:研究对象包括22例CD患者(CD组)和22例健康对照者(HC组)。经知情同意后抽取3 ml静脉血,肝素钠抗凝。流式细胞术(FCM)检测单核细胞亚群比例及其细胞内TNF-α平均荧光强度(MFI),并分析CD患者单核细胞亚群比例与血清细胞因子浓度的相关性。结果:CD组中间型单核细胞亚群比例明显高于HC组[(10.2±4.1)%vs(4.3±1.8)%],差异有统计学意义(P<0.05);CD组中间型单核细胞胞内TNF-αMFI高于HC组(44.5±6.4 vs 36.7±8.3),差异有统计学意义(P<0.05)。CD患者中间型单核细胞比例与外周血TNF-α浓度和克罗恩病活动指数(CDAI)具有相关性(分别为r=0.462、P=0.030,r=0.568、P=0.005)。结论:CD患者外周血单核细胞向中间型极化,并处于活化状态,分泌较多的促炎细胞因子TNF-α,参与CD的疾病过程。因此,抑制单核细胞向中间型极化可能是治疗CD的新途径。
OBJECTIVE: To investigate the role of monocyte subsets in the pathogenesis of CD by detecting the proportion of peripheral blood mononuclear cells and the function of secreting tumor necrosis factor-α (TNF-α) in Crohn’s disease patients. Methods: The subjects included 22 patients with CD (CD group) and 22 healthy controls (HC group). After informed consent to extract 3 ml of venous blood, heparin sodium anticoagulation. Flow cytometry (FCM) was used to detect the proportion of monocyte subsets and intracellular TNF-α mean fluorescence intensity (MFI). The correlation between monocyte subsets and serum cytokines was analyzed. Results: The proportion of intermediate monocyte subsets in CD group was significantly higher than that in HC group [(10.2 ± 4.1)% vs (4.3 ± 1.8)%], the difference was statistically significant (P <0.05) The intracellular TNF-αMFI was higher in HC group than in HC group (44.5 ± 6.4 vs 36.7 ± 8.3), with significant difference (P <0.05). The proportion of intermediate monocytes in CD patients correlated with TNF-α levels in peripheral blood and Crohn’s disease activity index (r = 0.462, P = 0.030, r = 0.568, P = 0.005, respectively). CONCLUSIONS: Peripheral blood mononuclear cells from patients with CD are polarized toward the middle and are activated, secreting more proinflammatory cytokine TNF-α, which is involved in the disease process of CD. Therefore, inhibition of monocyte to intermediate polarization may be a new way to treat CD.