中文摘要：

目的探讨脐带间充质干细胞（UC-MSCs）体内外对系统性红斑狼疮（SLE）患者CD3^＋CD8^-ILl7A^＋T淋巴细胞及相关细胞因子的调节作用。方法UC-MSCs移植治疗14例SLE患者，观察移植前后的临床表现及实验室指标的变化。采用流式细胞术检测各时间点患者外周血CD3^＋CD8-ILl7A^＋T细胞百分率，酶联免疫吸附试验（ELISA）测定血浆白细胞介素（IL）-6、转化生长因子（TGF）-B、IL-17A、IL-22表达水平。10例SLE患者外周血单个核细胞（PBMC）分别与UC—MSCs按不同比例体外共培养72h，流式细胞术检测PBMC中CD3^＋CD8-ILl7A^＋T细胞百分率。采用配对t检验和独立样本t检验。结果UC—MSCs移植后患者疾病活动指数评分（SLEDAI）在3个月（7．8±1．2，t=2．19）及6个月（6．9±0．9，t=4．2）均显著低于移植前（10.4±0．9，P〈O．05）；尿蛋白定量（24h）移植后6个月显著下降[（1489±260）与（2454±322）mg，t=2．6，P〈0．05]；血清白蛋白水平在移植后1、3、6个月均显著高于移植前（尸〈0．05），补体c3移植后持续升高。UC—MSCs移植后1个月及6个月，患者外周血CD3^＋CD8-ILl7A^＋T淋巴细胞百分率显著下降（P〈0．05）。UC—MSCs与SLE患者PBMC共培养可显著下调CD3^＋CD8-ILl7A^＋T淋巴细胞百分率（P〈0．05），但无剂量依赖性。UC—MSCs移植后患者血浆IL-6、TGF—β、IL-17A、IL-22水平与移植前比，差异无统计学意义（P〉O．05）。结论UC—MSCs移植治疗SLE有效，移植后SLE患者PBMC中CD3^＋CD8-ILl7A6＋T淋巴细胞水平显著下降。

英文摘要：

Objective To investigate the regulatory effects of umbilical cord-derived mesenchymal stem cells （UC-MSCs） on Thl7 cells and related cytokines in patients with systemic lupus erythematosus （SLE）. Methods Human UC-MSCs were isolated and expanded and infused into fourteen SLE patients. Clinical changes were evaluated before and after transplantation by SLE disease activity index （SLEDAI）, 24 hour urine protein, serum albumin and complement C3. The percentages of CD3 ^＋CD8^-IL17A^＋ T cells in peripheral blood were detected by flow cytometry. Concentrations of plasma IL-6, TGF-13, IL-17A, IL-22 were determined by enzyme-linked immunosorbent assay （ELISA）. UC-MSCs and peripheral blood mononuclear cells （PBMC） were co-cultured at different ratios （MSCs：PBMC=1：1, 1：5, 1：10） and the change of CD3^ ＋CD8^-IL17A^＋ T ceils were examined by flow cytometry.Data were analyzed with paired t-test, or with independent samples t-test. Results SLEDAI scores decreased significantly at 3 month （7.8±1.2, t=2.19） and 6 month （6.9±0.9, t=4.2） after UC-MSCs transplantation than pretransplantation level （10.4±0.9, P〈 0.05）. Twenty-four-hour proteinuria decreased significantly 6 months after MSCs infusion [ （1489±260） mg vs （2454±322） mg, t=2.6, P〈O.05]. Meanwhile, serum albumin and complement C3 levels had increased significantly since 1 month after transplantation （P〈0.05）. The percentages of peripheral blood CD3^＋CDS^-IL17A^＋T cells decreased obviously in 1 week, 1 month and 6 months after UC-MSCs transplantation （all P〈O.05）. The coculture of UC-MSCs with PBMC from SLE patients resulted in a statistically significant reduction of CD3^＋CDS^-IL17A^＋T cells percentage in PBMC （P〈0.05）, but was not in a dose dependent manner. No change of plasma IL-6, TGF-β, IL-17A and IL-22 levels was observed after UC-MSCs transplantation （P〉O.05）. Conclusion UC-MSCs transplantation down-regulates the percentages of CD3^＋CDS^-IL17A^＋T ceils in SLE pat