Expression of costimulatory molecule inducible costimulator and coinhibitory molecule programmed death-1 in patients with myasthenia gravis
10.3760/cma.j.issn.1006-7876.2018.02.005
- VernacularTitle:可诱导共刺激分子与程序性死亡-1在重症肌无力患者外周血表达的研究
- Author:
Caiqin WANG
1
;
Mingqiao YING
;
Qun XUE
;
Yanzheng GU
;
Xiaoyu DUAN
;
Hanqing GAO
;
Mingyuan WANG
;
Xiaopei JI
;
Xiaoming YAN
;
Qi FANG
;
Wanli DONG
;
Xueguang ZHANG
Author Information
1. 215006,江苏省苏州大学附属第一医院神经内科
- Keywords:
Myasthenia gravis;
Cytokines;
Flow cytometry;
Inducible costimulator;
Programmed death-1
- From:
Chinese Journal of Neurology
2018;51(2):105-110
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the immunopathological mechanism for the imbalance between the positive signal mediated by inducible costimulator (ICOS) and the negative signal mediated by programmed death-1 (PD-1) in patients with myasthenia gravis (MG).Methods Eighty-two patients with MG,56 healthy controls (HC) and 20 non-MG (NMG) patients,collected in the First Affiliated Hospital of Suzhou University from February 2014 to December 2016,were chosen to participate in the study.The expression of ICOS and PD-1 on peripheral blood mononuclear cells was detected by immuno-fluorescence staining and flow cytometry.The levels of soluble programmed death-1 (sPD-1),soluble programmed death ligand 1 (sPD-L1),IL-4 and other cytokines were detected by enzyme-linked immunosorbent assay.Results (1) Flow cytometry analysis:The co-expression of PD-1,ICOS on CD4 + T cells from MG group (9.64% (8.82%)) was higher than in HC (1.81% (2.10%),Z =-7.389,P <0.05) and NMG group (2.86% (1.49%),Z =-4.636,P < 0.05).The expression of ICOS on CD4 + T cells,ICOS ligand (ICOSL) on CD14+ monocytes and CD19+ B cells were increased in MG group comparing with that of the control groups.The proportion of PD-1 + CD4 + T cells (MG group 16.82% (10.66%),HC 9.34% (9.18%),Z =-4.345,P<0.05;NMG group 7.07% (3.40%),Z=-4.594,P<0.05) and PD-1 Ligand (PD-L1) + CD14+ monocytes was higher in MG patients.All of these were detected by flow cytometry.(2) ELISA analysis:Serum sPD-1 expression significantly increased in MG group compared with that in the control groups (MG group (1.87 ± 0.64) ng/ml,NMG group (1.49 ± 0.70) ng/ml,t =2.04,P < 0.05;HC (1.05 ± 0.50)ng/ml,t =2.08,P < 0.05),while for serum sPD-L1,there was no significant difference between MG and control groups.(3) Serum cytokines detection:The expression of IL-4 was increased in MG patients (MG group (61.88 ±5.15) pg/ml,HC (32.03 ±1.84) pg/ml,t=2.50,P<0.05;NMG group (42.62± 3.31) pg/ml,t =2.34,P <0.05),and there was a negative correlation between the expression of sPD-1 and the concentration of IL-4.Conclusions The increased expression of PD-1 + ICOS + CD4 + T cells suggested the subset involved in the pathological progress of MG.sPD-1 might disturb the ligation of PD-1 on T cells and PD-L1 on antigen presenting cells,while the ligation of ICOS and ICOSL passed positive signal,leading to over activity of the subsets and the progression of disease.