背景:CD20+T细胞占循环T淋巴细胞的5%。已显示这些细胞比CD20-T淋巴细胞产生更高水平的IL-17A和IFN-γ。一些报道描述了CD20+T细胞在自身免疫性疾病如多发性硬化和类风湿性关节炎中的作用,这可能是由于它们产生这些炎性细胞因子的能力。这项研究旨在描述CD20+T淋巴细胞在最常见的自身免疫性疾病中的行为,即,桥本甲状腺炎(HT),在多自身免疫框架中呈现孤立的或与进一步的自身侵袭性疾病相关的疾病。
方法:研究组包括65例HT患者:23例以孤立形式(IT)表现,42例伴有非内分泌自身免疫性疾病[16例伴有慢性萎缩性胃炎(CAG),15患有非节段白癜风(VIT),和11患有乳糜泻(CD)]。20名健康供体作为对照组(HD)。长期使用干扰药物,严重或慢性疾病,妊娠和泌乳被用作排除标准。全血样品(100μl)用荧光标记的抗体(抗CD45,抗CD3,抗CD19,抗CD16,抗CD56,抗CD4,抗CD8,抗CD20)染色。然后通过加入1ml低渗缓冲液裂解红细胞,和样品在流式细胞仪上采集。
结果:CD3+CD8+CD20+T淋巴细胞百分比,与健康供体相比,在整个自身免疫患者组中明显更高(p=0.0145)。根据自身免疫性甲状腺炎的表现类型划分HT患者,与HD和CD相比,CAG组显示出这些细胞的最高百分比(p=0.0058)。尽管未达到统计学意义,但IT患者显示CD3+CD8+CD20+细胞的百分比高于HD患者。然而,根据甲状腺功能划分IT组,甲状腺功能减退患者的CD8CD20细胞百分比高于HD和甲状腺功能正常患者(p=0.0111)。此外,在IT患者中,这些细胞与FT4水平呈负相关(p=0.0171;r=-0.4921)。
结论:这些初步研究结果表明,CD8+CD20+T细胞在患有自身免疫性甲状腺炎的患者中被激活,并且可能根据多自身免疫和甲状腺功能减退的存在而表现不同。
BACKGROUND: CD20+ T cells represent up to 5% of circulating T lymphocytes. These cells have been shown to produce higher levels of IL-17A and IFN-γ than those of CD20- T lymphocytes. Some reports described the role of CD20+ T cells in autoimmune disorders such as multiple sclerosis and rheumatoid arthritis possibly due to their ability to produce these inflammatory cytokines. This study is aimed at describing the behavior of CD20+ T lymphocytes in the most frequent autoimmune disorder, i.e., Hashimoto\'s thyroiditis (HT), presenting isolated or associated to further autoaggressive disorders in a frame of poly-autoimmunity.
METHODS: The study group encompasses 65 HT patients: 23 presenting in isolated form (IT) and 42 with an associated non-endocrine autoimmune disorder [16 with chronic atrophic gastritis (CAG), 15 with nonsegmental vitiligo (VIT), and 11 with celiac disease (CD)]. Twenty healthy donors act as control group (HD). Chronic use of interfering drugs, severe or chronic disorders, and pregnancy and lactation were used as exclusion criteria. Whole blood samples (100 µl) were stained with fluorescent-labeled antibodies (anti-CD45, anti-CD3, anti-CD19, anti-CD16, anti-CD56, anti-CD4, anti-CD8, anti-CD20). Red blood cells were then lysed by adding 1 ml of hypotonic buffer, and samples were acquired on a Flow Cytometer.
RESULTS: CD3+CD8+CD20+ T lymphocytes\' percentages, were significantly higher in the whole group of autoimmune patients compared to healthy donors (p = 0.0145). Dividing HT patients based on the type of presentation of autoimmune thyroiditis, CAG group showed the highest percentage of these cells as compared to HD and CD (p = 0.0058). IT patients showed higher percentages of CD3+ CD8+CD20+ cells than those of HD patients although not reaching statistical significance. However, dividing IT group based on thyroid function, hypothyroid patients showed higher CD8+CD20+ cell percentages than those of HD and euthyroid patients (p = 0.0111). Moreover, in IT patients, these cells were negatively correlated with FT4 levels (p = 0.0171; r = -0.4921).
CONCLUSIONS: These preliminary findings indicate that CD8+CD20+ T cells are activated in patients with autoimmune thyroiditis and may behave differently according to the presence of poly-autoimmunity and hypothyroidism.