Objective To investigate the diagnostic value of T cell receptor β chain variable region (TCRVβ) in peripheral blood of clinically isolated syndrome (CIS ) , relapsing-remitting multiple sclerosis (RRMS ) and secondary-progressive multiple sclerosis (SPMS ) patients. Methods Hospitalized patients of Xuanwu Hospital form 2012.08.20 to 2014.03.20 ,who met the inclusion and exclusion criteria ,were divided into 4 groups. Three experimental groups :CIS group of 30 patients , RRMS group of 40 patients , SPMS patients of 10 cases , and the control group:30 healthy volunteers. Sex and age were well matched. We took 2 mL EDTA anticoagulated peripheral blood from the subjects , then analyzed the polymorphism of TCRVβby flow cytometry. We got the statistic of qualitative and quantitative expression of TCRVβ (total of 24 subfamilies) . The usage of TCRVβcan be descripted by the number of the clonal expanded TCRVβfragments (expression ≥10％ of all TCRVβ) and expansion fraction (the accumulation of expansion degree ) . Results TCRVβ was significantly higher in the disease groups than the control group (P<0.01) , there were no significant difference between disease groups (P> 0.05) . Quantitative and qualitative analysis of TCRVβ:CD4+ TCRVβ 2 was significantly expanded in diseases groups ;CD8+ TCRVβ11 was significantly reduced in disease groups , CD4+TCRVβ21.3 of the CIS group was significantly decreased than the SPMS group. Receiver operating characteristic(ROC) curve analysis indicated that CD8+ TCRVβ11 fragments had some diagnostic value for MS , and CD4+TCRVβ21.3 fragments had some diagnostic value for SPMS. Conclusions The early diagnosis of MS and SPMS can be partly facilitated by detecting some TCRV β fragments.%目的 探讨多发性硬化(MS)不同阶段外周血T淋巴细胞受体β链可变区(TCRVβ)多态性的特点.方法 收集首都医科大学宣武医院神经内科临床孤立综合征(CIS)患者30例、复发-缓解型多发性硬化(RRMS)患者40例、继发-进展型多发性硬化(SPMS)患者10例、健康对照者30名,经TCRVβ单克隆抗体标记后采用流式细胞仪分析各组外周血TCRVβ扩增程度以及TCRVβ24个亚家族扩增患者百分比、扩增片段所占百分比的差异.结果 CIS、RRMS及SPMS组TCRVβ存在扩增患者比例、扩增个数和扩增分数均高于对照组(P<0.01),而CIS、RRMS及SPMS组间比较无统计学差异(P>0.05).CIS、RRMS及SPMS组CD4+TCRVβ2扩增频率均高于对照组(P<0.008),CIS组、RRMS及SPMS组CD8+TCRVβ11表达水平均低于对照组(P<0.05),SPMS组CD4+TCRVβ21.3表达水平低于CIS组(P<0.05).ROC曲线分析提示CD8+TCRVβ11的扩增片段所占百分比对MS诊断具有一定价值,对MS分型无诊断价值;CD4+TCRVβ21.3的扩增片段所占百分比对SPMS诊断具有一定价值.结论 可通过检测部分TCRVβ片段对MS及SPMS的早期诊断提供相关依据.
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