李凡　张升校　王兴羽　马腾　毛兴佳　蔡红艳　王彩虹

[摘要] 系统性红斑狼疮（systemic lupus erythematosus，SLE）是一种多系统损害的慢性自身免疫性疾病，其特征是自身抗体及免疫復合物沉积。在系统性红斑狼疮的慢性炎症过程中，CD4+T细胞亚群免疫平衡被破坏，尤其是Th1/Th2及Th17/Treg细胞失衡在系统性红斑狼疮的发生和发病机制中发挥关键作用。本文以免疫紊乱为切入点，分别从细胞计数、细胞因子、基因水平等方面综述系统性红斑狼疮与CD4+T细胞亚群的关系，希望为全面理解系统性红斑狼疮的发病机制以及免疫治疗提供更系统的理论支持。

[关键词] 系统性红斑狼疮；CD4+T细胞亚群；失衡；相关性

[中图分类号] R593.24 [文献标识码] A [文章编号] 1673-9701（2018）26-0159-05

Advances in the study of the pathogenesis of systemic lupus erythematosus with CD4+ T cell subsets

LI Fan1 ZHANG Shengxiao2 WANG Xingyu1 MA Teng2 MAO Xingjia2 CAI Hongyan3 WANG Caihong4

1.First Clinical Medical College of Shanxi Medical University，Taiyuan 030001，China；2.Second Clinical Medical College of Shanxi Medical University，Taiyuan 030001，China；3.Basic Medical College of Shanxi Medical University，Taiyuan 030001，China；4.Department of Rheumatology Immunity，Second Hospital of Shanxi Medical University，Taiyuan 030001，China

[Abstract] Systemic lupus erythematosus（SLE） is a chronically autoimmune disease with multiple systemic damages. It is characterized by deposition of autoantibodies and immune complexes. In the process of chronic inflammation of systemic lupus erythematosus， the immune balance of CD4+ T cell subsets is destroyed， especially the imbalance of Th1/Th2 and Th17/Treg cells plays a key role in the occurrence and pathogenesis of systemic lupus erythematosus. In this paper， taking the immune disorders as the starting point， from the cell count， cytokines， gene levels and other aspects respectively， we reviewed the relationship between systemic lupus erythematosus and CD4+ T cell subsets， hoped to provide a comprehensive understanding of the pathogenesis of systemic lupus erythematosus and a more systematic theoretical support for immunotherapy.

[Key words] Systemic lupus erythematosus；CD4+ T cellsubsets；Imbalance；Related

系统性红斑狼疮（systemic lupus erythematosus，SLE）是一种全身性的自身免疫性疾病，其特征是对抗原的免疫应答和免疫复合物沉积，引起靶器官炎症和组织损伤。初始CD4+T细胞受到抗原刺激后可产生Th1、Th2、Th17、调节性T细胞（regulatory T cell，Treg）等向不同的方向分化的细胞，这种分化的失衡可以导致多种疾病的发生。CD4+T细胞亚群免疫紊乱继发的细胞因子改变、补体激活、克隆B细胞活化导致了自身抗体的过度产生和组织损伤。辅助性T细胞（Th）亚群如Th1、Th2、Th17细胞与调节性Treg细胞的平衡失调在SLE发病中起着重要的作用，本文主要从Th1/Th2及Th17/Treg的角度分别从细胞计数、细胞因子、基因水平等方面阐述其与SLE的关系，并为临床治疗提供新的思路。

1 Th1/Th2细胞失衡与SLE

1.1 Th1/Th2细胞的分化与平衡

辅助CD4+T细胞能分化为Th1细胞，其产生的主要细胞因子有白介素2（IL-2）、肿瘤坏死因子β（TNF-β）和干扰素γ（IFN-γ），见图1，介导细胞免疫；……