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目的探究视神经脊髓炎谱系病(NMOSD)患者外周血滤泡辅助性T细胞(Tfh)百分率在甲泼尼龙冲击治疗前、后的变化。方法收集AQP-4抗体阳性的急性期NMOSD患者(NMOSD组)23例,采用流式细胞术检测甲泼尼龙冲击前、后外周血CXCR5~+ICOS~+的CD4~+T细胞(Tfh细胞),记录NMOSD组的EDSS评分,分析NMOSD组患者Tfh细胞百分率与患者AQP-4抗体滴度及EDSS评分的相关性。结果 NMOSD组患者甲泼尼龙冲击治疗前外周血Tfh细胞百分率[(1.77±0.74)%]显著高于甲泼尼龙冲击治疗后[(1.26±0.45)%](t=2.284,P=0.032)。首次发病NMOSD患者甲泼尼龙冲击治疗前Tfh细胞百分率与EDSS评分呈正相关(r=0.625,P=0.040),甲泼尼龙冲击治疗前、后Tfh细胞百分率与AQP-4抗体滴度无相关性(r=--0.02,P=0.928)。结论经甲泼尼龙冲击治疗后,NMOSD患者急性期外周血Tfh细胞百分率降低,首次发病NMOSD患者Tfh细胞百分率水平与EDSS评分有关。Tfh细胞百分率水平可能与NMOSD的复发有关。
Objective To investigate the changes of the percentage of peripheral blood follicle-helper T cells (Tfh) in patients with optic neuromyelitis spectrum (NMOSD) before and after treatment with methylprednisolone. Methods Twenty-three patients with AQP-4 positive acute phase of NMOSD were collected. Flow cytometry was used to detect the levels of CXCR5 + ICOS + CD4 + T cells (Tfh cells) in peripheral blood before and after methylprednisolone treatment. The EDSS score of the NMOSD group was recorded. The correlation between the percentage of Tfh cells in patients with NMOSD and the titer of AQP-4 antibody and EDSS score was analyzed. Results The percentage of Tfh cells in peripheral blood before methylprednisolone treatment was significantly higher in patients with NMOSD ([1.77 ± 0.74]% vs [1.26 ± 0.45]%] (t = 2.284, P = 0.032). There was a positive correlation between the percentage of Tfh cells and the EDSS score before the initial onset of NMOSD (r = 0.625, P = 0.040). The percentage of Tfh cells before and after methylprednisolone treatment did not correlate with the titer of AQP-4 antibody r = -0.02, P = 0.928). Conclusions After acute methylprednisolone treatment, the percentages of Tfh cells in peripheral blood of patients with NMOSD decreased, and the percentage of Tfh cells in first onset NMOSD patients was related to EDSS score. Tfh cell percentage levels may be related to the recurrence of NMOSD.