Objective To study the changes and significance of the frequencies of circulating follicular helper T cells (cTfh) and circulating regulatory follicular T cells (cTfr) as well as the cTfh/cTfr ratio in neuromyelitis optica spectrum disorder (NMOSD).Methods The frequencies of cTfh,cTfr and B cells in patients with NMOSD and health controls(HCs) were measured by flow cytometry.Enzyme-linked immunosorbent assay was used to detect the level of IL-21 and AQP4-Ab in patients and HCs.Results The frequencies of cTfh and B cells,the cTfh/cTfr ratio and the plasma level of IL-21 werc significantly higher in the relapsing patients than those in the remitting patients and HCs(P ＜ 0.05),and the cTfr level in the relapsing patients was lower than that in the remitting patients and healthy population (P ＜ 0.05).But no statistical differences were observed in the above indexes between the remitting paticnts and HCs.There was also no significant difference in AQP4-Ab level between the patients with relapse and remission (P ＞ 0.05).The frequency of cTfh in the patients wasc positively correlated with the level of B cells and IL-21(P ＜ 0.05),and the frequency of cTfr was negatively correlated with B cells and IL-21 (P ＜ 0.05).The ratio of cTfh/cTfr was positively correlated with B cell frequency and IL-21 level (P ＜ 0.05).AQP4-Ab level had no correlation with the frequencies of cTfh cells and B cells,cTfh/cTfr ratio and IL-21 concentration (P ＞ 0.05).Conclusion The changes in the frequencies of cTfh and cTfr as well as the imbalanced cTfh/cTfr ratio may promote the activation of humoral immunein NMOSD and participate in the pathogenesis of this disease.%目的:探讨循环滤泡辅助性T细胞(cTfh)、循环滤泡调节性T细胞(cTfr)以及cTfh/cTfr比值在视神经脊髓炎谱系疾病(NMOSD)病程中的变化及意义.方法:流式细胞术检测15例复发期、16例缓解期NMOSD患者及18例健康对照者的cTfh、cTfr及外周血B细胞比率;酶联免疫吸附试验检测3组受试者血浆IL-21以及患者血浆抗水通道蛋白4抗体(AQP4-Ab)水平.结果:与缓解期患者和健康人相比,复发期患者cTfh和B细胞比率、cTfh/cTfr比值以及IL-21水平均升高,cTfr比率降低;而缓解期患者与健康人的上述指标相比差异无统计学意义.复发期和缓解期患者AQP4-Ab无明显差异.患者的cTfh比率与B细胞比率、血浆IL-21水平呈正相关,而cTfr比率与IL-21水平之间呈负相关.患者cTfh/cTfr比值与B细胞比率和IL-21之间亦呈正相关,但AQP4-Ab水平与cTfh比率、B细胞比率、cTfh/cTfr比值以及IL-21没有相关性.结论:NMOSD患者cTfh和cTfr比率的变化以及cTfh/cTfr比值失衡可能促进机体内体液免疫应答异常活化,从而参与NMOSD的发病.
展开▼
