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- W3104483166 abstract "Objective: To explore the associations of regulatory B cells (Breg cells) and regulatory T cells (Treg cells) with the clinical effect of Infliximab in the treatment of Chinese patients with Crohn's disease (CD). Methods: From January 2017 to June 2019, a total of 32 CD patients at active stage and 33 age and gender-matched healthy controls were collected from the Second Affiliated Hospital of Wenzhou Medical University in this study. Approximate 5 ml of peripheral fasting venous blood was obtained from every subject. Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood. Then multi-color flow cytometry was applied to determine the proportion of Breg (CD3-CD19+IL-10+B cells) in B cells and the proportion of Treg (CD4+CD25+Foxp3+T cells) in CD4+T cells. Infliximab (5 mg/kg) was given intravenously at week 0, 2 and 6 to induce CD remission, and then maintained with the same dose of Infliximab every 8 weeks. And the proportions of Breg and Treg were examined at week 14 of Infliximab treatment, then compared with those of week 0. Simultaneously, C-reactive protein (CRP), leucocyte count, platelet count, erythrocyte sedimentation rate were detected in CD patients to assess the clinical effect at week 0 and 14 of Infliximab treatment. Results: Before infliximab treatment, compared with healthy controls, the proportion of Breg in B cells was significantly increased [(3.15±1.17)% vs (2.64±0.38)%, P=0.024)], and the proportion of Treg in CD4+T cells was significantly decreased [(2.15±0.49)% vs (4.25±0.41)%, P<0.001] in CD patients. And the proportion of Breg was positively related with the proportion of Treg in CD patients either at week 0 or week 14 of Infliximab treatment (r=0.628, P<0.001; r=0.749, P<0.001). At week 14 of Infliximab treatment, according to symptoms, Crohn's disease activity index (CDAI) and endoscopic mucosal healing, CD patients were classified as remission group (CDAI<150 and endoscopic mucosal healing, R group) and non-remission group (CDAI≥150 or mucosal non-healing group, N group). Compared with CD patients at week 0 of Infliximab treatment, both the proportion of Breg and Treg were significantly enhanced [(5.89±2.60)% vs (3.19±1.27)%, P<0.001; (4.59±0.72)% vs (2.08±0.47)%, P<0.001], whereas CDAI and CRP was significantly reduced [CDAI: (63.19±14.69) vs (195.62±58.13), P<0.001; CRP: (3.65±2.23) mg/L vs (29.80±30.06) mg/L, P<0.001] in R group at week 14 of Infliximab treatment. The proportions of Breg and Treg were negatively related with the CRP (r=-0.279, P=0.026; r=-0.406, P=0.001) and CDAI (r=-0.409, P=0.001; r=-0.708, P<0.001) in CD patients at week 0 and 14 of Infliximab treatment. At week 14 of Infliximab treatment, ROC curve analysis showed that the predictive value of Breg+Treg for the effect of Infliximab was higher than the other parameters (area under ROC: 0.782, cutoff value: 0.895 5, P=0.034). Conclusions: Breg cells and Treg cells are not only significantly correlated with CD disease activity, but the combined detection of the two types of immune cells has higher clinical value for predicting the effect of Infliximab in CD patients at active stage.目的: 探讨外周血调节性B细胞(Breg细胞)和调节性T细胞(Treg细胞)与英夫利昔单抗治疗克罗恩病临床疗效的关系。 方法: 2017年1月至2019年6月期间,在温州医科大学附属第二医院收集32例活动期克罗恩病患者和33名性别、年龄相匹配的健康对照者。取空腹静脉血5 ml,分离外周血单个核细胞(PBMCs),经多色流式细胞术检测PBMCs中Breg细胞(CD3-CD19+IL-10+B细胞)占B细胞的比例,以及Treg细胞(CD4+CD25+Foxp3+T细胞)占CD4+T细胞的比例。克罗恩病患者于第0、2、6周静脉注射英夫利昔单抗(5 mg/kg)诱导缓解,其后每隔8周给予相同剂量的英夫利昔单抗维持治疗。于第14周再次检测PBMCs中Breg细胞比例和Treg细胞比例,并与第0周进行比较。同时,克罗恩病患者分别于第0周和第14周检测C反应蛋白(CRP)、白细胞计数、血小板计数、血细胞沉降率辅助评估英夫利昔单抗疗效。 结果: 英夫利昔单抗治疗前,克罗恩病组与健康对照组之间整体比较,PBMCs中Breg细胞比例较高[(3.15±1.17)%比(2.64±0.38)%,P=0.024],Treg细胞比例较低[(2.15±0.49)%比(4.25±0.41)%,P<0.001]。英夫利昔单抗治疗前和治疗第14周,克罗恩病组中Breg细胞比例和Treg细胞比例均呈独立正相关(r=0.628,P<0.001;r=0.749,P<0.001)。治疗第14周,根据症状、克罗恩病活动指数(CDAI)、内镜下黏膜愈合进行评估。CDAI<150且内镜下黏膜愈合者定义为缓解组(R组),CDAI≥150或内镜下黏膜未愈合者为未缓解组(N组)。治疗第14周与治疗前比较,R组中Breg细胞比例和Treg细胞比例均显著增高[(5.89±2.60)%比(3.19±1.27)%,P<0.001;(4.59±0.72)%比(2.08±0.47)%,P<0.001],CDAI和CRP均显著降低[CDAI:(63.19±14.69)比(195.62±58.13),P<0.001;CRP:(3.65±2.23) mg/L比(29.80±30.06) mg/L,P<0.001]。治疗前和第14周,克罗恩病患者中Breg细胞比例和Treg细胞比例与CRP(r=-0.279,P=0.026;r=-0.406,P=0.001)和CDAI(r=-0.409,P=0.001;r=-0.708,P<0.001)始终呈独立负相关。治疗第14周,ROC曲线分析显示Breg细胞比例+Treg细胞比例对英夫利昔单抗疗效的预测价值高于其他参数(曲线下面积:0.782,截断值:0.895 5,P=0.034)。 结论: Breg细胞和Treg细胞不仅与克罗恩病疾病活动密切相关,而且在活动期克罗恩病患者中,联合检测这两类免疫细胞对英夫利昔单抗疗效的预测价值更高。." @default.
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- W3104483166 date "2020-11-17" @default.
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- W3104483166 title "[Association of Breg cells and Treg cells with the clinical effects of Infliximab in the treatment of Chinese patients with Crohn's disease]." @default.
- W3104483166 doi "https://doi.org/10.3760/cma.j.cn112137-20200215-00298" @default.
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