【摘要】：目的:分析p DC在p SS外周血中表達和唇腺組織中浸潤情況,白芍總苷(total glucosides of paeony,TGP)對原發(fā)性干燥綜合征(primary Sj?gren’s syndrome,p SS)患者外周血漿細胞樣樹突狀細胞(plasmacytoid dendritic cells,p DCs)的影響,探討白芍總苷對原發(fā)性干燥綜合征的治療作用機制。方法:募集17例新發(fā)的原發(fā)性干燥綜合征患者作為疾病組,予以白芍總苷每日1.8克(0.6g tid)治療3月,健康成人17例作為對照組,收集疾病組治療前后臨床及實驗室資料,包括血常規(guī)、血沉、免疫球蛋白等,評估ESSDAI評分;分別收集疾病組白芍總苷治療前、治療后及對照組外周全血5ml,EDTA抗凝,提取血漿1ml,密度梯度離心法分得外周血單個核細胞(PBMC),采用流式細胞術(shù)檢測3組p DCs(Lin-CD123+HLA-DR+)及其表面CD32、CD86、CXCR4和Bly S表達情況,Flow Jo 7.6.1軟件分析;ELISA法檢測疾病組白芍總苷治療前、治療后及對照組血漿IFN-α,IL-6,TNF-α水平;收集25例唇腺活檢證實為灶性淋巴細胞浸潤的原發(fā)性干燥綜合征患者唇腺組織,免疫組化法檢測唇腺組織p DCs(IL-3R/CD123+)浸潤及p DCs表達CD32+、CXCR4+情況。結(jié)果:1、pSS患者外周血pDCs比例較健康對照組下降(0.017±0.012,0.028±0.01;q=3.451,p0.05),表達CXCR4比例較健康對照組增加(q=8.18,p0.05);外周血p DCs比例與抗核抗體滴度成正相關(guān)(r=0.755,p=0.002);血漿IL-6、TNF-α、IFN-α水平較健康對照組上升(1.61±0.14,1.49±0.08;q=4.437,p0.05);(17.53±5.84,13.61±4.01;q=3.512,p0.05);(8.91±5.05,5.15±1.43;q=3.381,p0.05)。2、白芍總苷治療后,p SS患者外周血p DCs比例較治療前上升(0.017±0.012,0.029±0.014;q=3.902,p0.05),p DCs表達CXCR4、Bly S比例較治療前下降(q=4.272,p0.05),(q=3.048,p0.05)。血沉下降(34.85±24.1,20.9±15.34;t=2.369,p=0.033)。血漿IL-6、TNF-α水平較治療前下降(1.51±0.10,1.61±0.14;q=3.337,p0.05);(17.53±5.84,13.97±3.03;q=3.092,p0.05)。3、25例p SS患者唇腺組織中19例有p DCs浸潤。結(jié)論:新發(fā)p SS患者較正常人外周血p DCs比例降低,表達CXCR4增加,唇腺組織中p DCs增加;白芍總苷抑制p SS患者外周血中p DCs活化,減輕炎癥性細胞因子IL-6,TNF-α表達。
[Abstract]:Objective: to analyze the expression of p-DC in peripheral blood and the infiltration of labial gland in PSS. The effect of total glucoside of paeony (total glucosides of paeony TGP) on plasma cell like dendritic cells (plasmacytoid dendritic cells / DCs) in peripheral blood of patients with primary Sj?gren's syndrome (PSS) was studied. To investigate the therapeutic mechanism of total glucosides of paeony on primary Sjogren's syndrome. Methods: seventeen newly diagnosed patients with primary Sjogren's syndrome (PSS) were recruited as the disease group and treated with total glucoside of paeony (1.8g / tid) for 3 months, and 17 healthy adults as control group. The clinical and laboratory data were collected before and after treatment in the disease group. Including routine blood test, erythrocyte sedimentation rate, immunoglobulin and so on, to evaluate the ESSDAI score, collect the total glucosides of paeony before, after treatment and control group, and collect 5ml EDTA anticoagulant in the peripheral whole blood of the disease group before, after treatment and in the control group respectively. (PBMC), of peripheral blood mononuclear cells was isolated by density gradient centrifugation. Flow cytometry was used to detect the expression of CD32, CD86, CXCR4 and Bly S on peripheral blood mononuclear cells. Flow Jo 7.6.1 software was used to analyze the expression of CD32, CD86, CXCR4 and Bly S in peripheral blood mononuclear cells. The plasma levels of IFN- 偽 and IL-6 TNF- 偽 were collected from 25 patients with primary Sjogren's syndrome whose labial gland biopsy was confirmed as focal lymphocytic infiltration. The infiltration of p DCs (IL-3R/CD123 and the expression of CD32 CXCR4 in the labial gland were detected by immunohistochemical method. 緇撴灉:1,pSS鎮(zhèn)ｈ，

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