调节性B细胞在天疱疮患者外周血中的水平及临床意义
Number of regulatory B cells in peripheral blood in pemphigus patients and its clinical significance

目的·探讨天疱疮患者外周血调节性B细胞的水平及其在天疱疮发病中的意义。方法·选取天疱疮患者40例，正常对照组20例，抽取外周静脉血，流式细胞术检测外周血中CD19+ B细胞和刺激5 h、48 h后CD19+IL-10+ B细胞水平；酶联免疫吸附法检测血清中抗dsg1和抗dsg3抗体滴度。结果·天疱疮患者外周血CD19+ B细胞比例与正常对照组差异无统计学意义（P>0.05），CD19+ B细胞在急性发作期、慢性活动期及稳定期的天疱疮患者中差异亦无统计学意义（P>0.05）。体外刺激5 h后，天疱疮患者外周血CD19+IL-10+B细胞水平显著高于正常对照组（P=0.008），但在刺激48 h后，2组差异无统计学意义（P>0.05）。20例寻常型天疱疮患者中，急性发作期和慢性活动期患者的抗dsg3抗体滴度均显著高于稳定期患者（P<0.05）；20例落叶型天疱疮患者中，急性发作期和慢性活动期患者的抗dsg1抗体滴度均显著高于稳定期患者（P<0.05）。结论·天疱疮患者血清中致病性自身抗体滴度水平与B细胞数量无关，与疾病活动期有关；天疱疮患者外周血调节性B细胞功能可能存在缺陷。
： Objective · To explore the number of regulatory B cells in peripheral blood in patients with pemphigus and its significance in the incidence of pemphigus. Methods · Peripheral venous blood specimens were collected from 40 patients with pemphigus and 20 healthy controls. Flow cytometry was conducted to measure the number of CD19+IL-10+ B cells after stimulation for 5 and 48 h and the number of CD19+ B cells in peripheral blood. The serum anti-dsg1 antibody and anti-dsg3 antibody titers were measured with ELISA. Results · The difference in the proportion of CD19+ B cells in peripheral blood between pemphigus patients and healthy controls was not statistically significant (P>0.05). There was no significant difference in CD19+ B cells in pemphigus patients at acute onset, chronic active and remittent stages (P>0.05). The number of CD19+IL-10+B cells was significantly higher in pemphigus patients than in healthy controls 5 h after in vitro stimulation (P=0.008). However, the difference between two groups was not statistically significant 48 h after stimulation (P<0.05). In 20 PV patients, the anti-dsg3 antibody titers were significantly higher in patients at acute onset and chronic active stages than in patients at remittent stage (P>0.05). In 20 PF patients, the anti-dsg1 antibody titers were significantly higher in patients at acute onset and chronic active stages than patients in remittent stage (P<0.05). Conclusion · The pathogenic antibody titers in pemphigus patients are not associated with the number of B cells but are associated with disease activity. The function of regulatory B cells in peripheral blood in pemphigus patients may have defects