Analysis of lymphocyte subsets in bronchoalveolar lavage fluid of patients with dermatomyositis/polymyositis-associated interstitial lung disease
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摘要: 目的 探讨皮肌炎/多发性肌炎相关性间质性肺病(DM/PM-ILD)患者支气管肺泡灌洗液(BALF)中淋巴细胞计数及不同淋巴细胞亚群的分布特征,为进一步研究DM/PM-ILD发病机制提供理论依据。 方法 2013年1月-9月安徽省立医院收治的16例DM/PM-ILD患者行经支气管肺泡灌洗,获得BALF,并行总细胞计数及分类细胞计数。流式细胞术检测BALF及外周血中淋巴细胞亚群(CD3+总T细胞、CD3+CD4+ T细胞、CD3+CD8+ T细胞、CD3-CD16+CD56+ NK细胞、CD3-CD19+ B细胞),计算每种淋巴细胞亚群百分比。比较DM/PM-ILD患者与正常对照BALF中细胞总数及各淋巴细胞亚群百分比。比较DM/PM-ILD患者BALF与外周血各淋巴细胞亚群百分比。 结果 DM/PM-ILD患者外周血不同淋巴细胞百分比大多均正常;BALF细胞总数较正常对照显著增多,明显淋巴细胞占优势(每例均>15%)。DM/PM-ILD患者BALF中CD3+总T细胞和CD8+ T细胞百分比较正常对照显著增加,并且较外周血中百分比显著增加;DM/PM-ILD患者BALF中NK细胞百分比较正常对照显著下降,B细胞百分比与正常对照差异无统计学意义,两者均较外周血中显著下降。 结论 DM/PM-ILD患者BALF中存在明显的淋巴细胞计数增多和淋巴细胞亚群比例失调,其中CD8+ T细胞明显增加,可能在DM/PM-ILD形成中发挥重要作用。
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关键词:
- 皮肌炎/多发性肌炎 /
- 间质性肺病 /
- 淋巴细胞亚群 /
- 支气管肺泡灌洗液 /
- CD8+ T淋巴细胞
Abstract: Objective To explore the cell counts and distribution features of lymphocytes in bronchoalveolar lavage (BAL) fluid of the patients with dermatomyositis/polymyositis-associated interstitial lung disease (DM/PM-ILD). Methods Total 16 patients with DM/PM-ILD underwent BAL and got BAL fluid. The cells in BAL fluid were counted in all and in differentiation. The lymphocyte subsets in BAL fluid and peripheral blood were detected by flow cytometry. The lymphocyte subsets included CD3+ total T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, CD3-CD16+CD56+ NK cells, and CD3-CD19+ B cells. The counts of total cells and the percentages of lymphocyte subsets in BAL fluid were compared between DM/PM-ILD group and normal control. The percentages of lymphocyte subsets were compared between BAL fluid and peripheral blood in DM/PM-ILD patients. Results The percentages of different lymphocyte subsets in peripheral blood were normal except lowered percentages of CD4+ T cell, NK cell, and B cell in one patient. There were more cells in BAL fluid of DM/PM-ILD group than in normal control. Moreover, lymphocytes significantly predominated (by 15%). The percentages of CD3+ total T cell and CD8+ T cell in BALF of DM/PM-ILD patients were more than those in normal control, and more than those in peripheral blood of patients significantly; the percentage of NK cell was less than in normal control; and the difference of B cell percentages was not significant between DM/PM-ILD group and normal control. The percentages of NK cell and B cell in BALF were all less than those in peripheral blood in DM/PM-ILD patients. Conclusion There are significantly elevated lymphocytes and the imbalance of lymphocyte subsets in BAL fluid of DM/PM-ILD patients, especially for CD8+ T lymphocytes, which may play an important role in the development of ILD in DM/PM.
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