| Objective:Thymoma is the most common malignant tumor of epithelial origin in anterior mediastinal tumors.It is often associated with a variety of autoimmune diseases such as myasthenia gravis(MG).However,the pathogenesis of MG caused by thymoma is still under study.Current research believes that Treg cells are an important subset of cells in the body that maintain immune tolerance and negatively regulate immune responses,and play an important role in the pathogenesis of autoimmune diseases,infections,cancer,transplantation,allergies and other diseases.Teff is a large subpopulation including Th cells,Tfh cells,and Tc/CTL cells.It is mainly responsible for the body’s immune response and fulfills the functions of immune surveillance and defense.Treg interacts with Teff to form a regulatory network for immune tolerance and immune response,and together maintain the body’s normal immune function.Treg impaired expression of Treg and Teff can cause autoimmune diseases such as MG.This study intends to prove that there is an imbalance of Treg/Teff ratio in the peripheral blood and thymoma tissues of patients with thymoma combined with MG through the experiments on the peripheral blood and thymoma tissues of thymoma patients.We hope that our research can further clarify the role and possible mechanism of Treg/Teff expression imbalance in thymoma with myasthenia gravis.Methods:(1)Six patients with simple thymoma,thymoma combined with MG were selected,and the total age difference between the two groups was strictly controlled<10 years old.The general data of the patients and various immune indicators before surgery were analyzed.The patients were fasted in the early morning of the second day of admission3m L of peripheral blood was drawn(patients obtained informed consent in this experiment),peripheral blood mononuclear cells(PBMC)were isolated,and flow cytometry was used to detect the expression levels of Treg and Teff cells and their subpopulations;(2)12 of the above patients with simple thymoma and thymoma combined with MG,thymoma tissue was taken during thymoma resection,than the expression level of Treg cells(CD4~+、CD25~+、CD127~+)and Teff cells(CD44~+、CD62L~+、CCR7~+)in thymoma was detected by multi-label immunohistochemistry after preparation.Results:(1)Compared with simple thymoma in patients with thymoma and MG,Ig E was significantly increased,C3 was significantly decreased,and there was no significant difference in other clinical and laboratory indicators.(2)Among the 12 patients enrolled,Treg cells in peripheral blood were significantly lower in the MG group than in the Tm group(4.53±1.17%and 6.55±1.10%,respectively,P=0.012),while the Teff cells in the MG group were significantly higher than the Tm group(respectively:69.48±5.31%and 58.54±6.37%,P=0.009),the difference was statistically significant.(3)Compared with the Tm group,the CD39+Treg cells in the MG group were reduced(3.95±0.85%and 5.33±0.92%,P=0.022,respectively).The difference was statistically significant.Compared with Tm group in MG group,Tfh in Teff(4.86±1.20%and 2.99±1.45%respectively,P=0.035),Tfh1(11.59±2.00%and 6.77±1.58%respectively,P=0.001),Tfh17(respectively 36.87±6.01%and 26.00±5.11%,P=0.007)The number of cells increased,and the difference was statistically significant.(4)Among the 12 patients enrolled in the group,Treg cells in thymoma tissue were significantly lower than those in Tm group(22.83±5.24 and 55.67±14.67,P=0.001),while Teff cells were significantly higher in MG group than Tm group(125.17±42.03And 19.33±9.41,P=0.000),the difference is statistically significant.Conclusion:In patients with thymoma and MG,there is an imbalance of Treg/Teff expression characterized by Treg damage in peripheral blood,and the expression level in thymoma tissue shows the same result.As a result,Teff’s hyperstimulation cannot be inhibited,and Treg/Teff expression imbalance is caused MG to occur. |
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