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背景:树突状细胞(dendriticcell,DC)与免疫激活和免疫耐受关系密切,其与风湿病的研究处于开始阶段。目的:探讨滑膜树突状细胞在类风湿关节炎(rheumatoidarthritis,RA)中的作用。设计:非随机对照的实验研究。地点和对象:45例标本取自在解放军海军总医院行膝关节镜检查或治疗的RA和创伤患者关节滑膜。采集各例病史、体格检查、实验室检查和影像学资料。其中RA组包括RA患者25例;对照组为创伤患者20例,包括半月板损伤和交叉韧带断裂患者。采用免疫组织化学方法观察滑膜中HLA-DR抗原阳性表达细胞、S-100阳性和CD1a阳性的细胞的多少和分布情况。主要观察指标:两组患者滑膜中HLA-DR抗原阳性表达细胞、S-100阳性和CD1a阳性的DC的多少和分布情况。结果:RA滑膜中23例滑膜细胞HLA-DR表达阳性,19例S-100表达阳性,16例CD1a表达阳性,其阳性例数的百分率均高于对照组。RA组患者滑膜中HLA-DR,S-100和CD1a标记阳性细胞数犤(27.8±14.8%),(6.2±4.3%),(3.9±3.7%)犦均明显高于对照组犤(9.9±7.4)%,(2.8±2.3)%,(1.6±1.9)%犦(t=3.016,2.937,P<0.01;t=2.462,P<0.05)。结论:RA滑膜中DC和被激活的DC及HLA-DR阳性细胞的存在和增多可能在RA病变局部提呈自身抗原的过程中起重要的作用,是RA自身免疫异常的重要的始发因素。
BACKGROUND: Dendritic cells (DCs) are closely related to immune activation and immune tolerance, and their research on rheumatism is in its infancy. Objective: To investigate the role of synovial dendritic cells in rheumatoid arthritis (RA). Design: Non-randomized controlled experimental study. Location and Subjects: Forty-five specimens were obtained from synovial joints of RA and trauma patients who underwent knee arthroscopy or treatment at People’s Liberation Army Navy General Hospital. Each case history, physical examination, laboratory tests and imaging data. Among them, RA group included 25 cases of RA patients and control group was 20 cases of trauma patients, including meniscus injury and cruciate ligament rupture. The number and distribution of HLA-DR antigen positive cells, S-100 positive cells and CD1a positive cells in synovium were observed by immunohistochemistry. MAIN OUTCOME MEASURES: The number and distribution of HLA-DR antigen-positive cells, S-100 positive and CD1a-positive DCs in synovium of two groups of patients. Results: The expression of HLA-DR in 23 synovial cells of RA synovial cells was positive, the positive expression of S-100 in 19 cases and the positive expression of CD1a in 16 cases were higher than those in control group. The number of HLA-DR, S-100 and CD1a positive cells in RA group was significantly higher than that in control group (9.9%, 27.8 ± 14.8%, 6.2 ± 4.3%, 3.9 ± 3.7% ± 7.4%, 2.8 ± 2.3%, 1.6 ± 1.9% 犦 (t = 3.016,2.937, P <0.01; t = 2.462, P <0.05). CONCLUSIONS: The presence and increase of DCs and activated DCs and HLA-DR positive cells in RA synovium may play an important role in the local presentation of autoantigens in RA lesions and are important initiators of RA autoimmune abnormalities .