Expression And Significance Of Peripheral Blood Lymphocytes Subsets And CD4+T Cell Subsets In Rheumatoid Arthritis

Objective:Comparison of peripheral blood lymphocyte subsets between rheumatoid arthritis(RA)patients and healthy people.To compare the absolute number of CD4+T cell subsets in peripheral blood of RA patients and healthy people.To compare the differences of peripheral blood lymphocyte subsets and CD4+T cell subsets between early RA group and non-early RA group;To compare the difference of CD4+T cell subsets in peripheral blood between the patients with primary RA and those with secondary RA.Patients with RA were divided into low activity group(?3.2),medium activity group(3.2-5.1)and high activity group(>5.1)according to disease activity score(DAS28),and to compare the differences of Th17 and Treg cells and their ratios in peripheral blood between each group and healthy people.Methods:Patients with RA(n = 137)and healthy controls(n = 50)were included in our study.Peripheral blood lymphocyte subsets and CD4+T cell subsets were detected by FCM,and collected Clinical data including gender,age,course of disease,DAS28 score..The absolute counts of peripheral blood lymphocyte subsets and CD4+T cell subsets in patients with early RA(disease duration ? 2 years)and established RA patients(disease duration >2 years)were compared to evaluate the immune function of patients with different disease courses.The absolute counts of CD4+T cell subsets in peripheral blood in first-therapy(newly diagnosed)and retherapy(DMARDs ? 6 months,Not stopdrug)patients and healthy controls were compared to evaluate the effect of treatment and non-treatment on the immune status of RA patients.Stratified according to the DSA28 score,the absolute counts of Th17 cells and Treg cells and the ratio of Th17 versus Treg cells in peripheral blood between different disease activity groups and the healthy control group were compared.Results:There were no statistically significant differences in total T,total B,Ts,CD4+/CD8+,T+B+NK cells between RA patients and healthy controls,while Th cells in RA patients were significantly higher than those in healthy controls(P<0.05)and NK cells were significantly lower than those in healthy controls(P<0.05).Absolute counts of CD4+T cell subsets in RA patients and healthy people were compared.In addition to Th17 cells,differences in Th1,Th2,Treg,Th1/Th2 and Th17/Treg between RA patients and healthy controls were statistically significant(P<0.05).Comparison of lymphocyte subsets between early RA patients and non-early RA patients showed no statistical difference in total B,Th,Ts,CD4+/CD8+,NK,T+B+NK cells,while the total T of non-early RA patients was significantly lower than that of early RA patients,and the difference was statistically significant(P<0.05).Comparison of CD4+T cell subsets between the primary treatment group and the secondary treatment group and the healthy control group showed that Th1,Th2,Th1/Th2 and Th17/Treg were statistically significant(P<0.05).But,there was no significant difference in the absolute count of Th17 and Treg cells.In different disease activity stratification of RA,the absolute number of Treg cells was lower than that of the healthy control group,and the difference was not statistically significant.In different disease activity stratification of RA,the absolute number of Th17 cells was higher than that of the healthy control group,and the difference between the absolute number of Th17 cells in 3.2<DSA28?5.1 group and that in healthy people was statistically significant(P<0.05).Th17/Treg was significantly higher in the DSA28 ?3.2 group and 3.2<DSA28 ?5.1 group than in the control group,and the difference was statistically significant(P<0.05).Conclusion:Th1/Th2 ? Th17/Treg balance disorder may be an important reason for the occurrence and development of RA.