Effects of CXCR4 Expression on Memory CD4+ T Cells in the Peripheral Blood of Rheumatoid Arthritis Treated by Combined Therapy of Bitongding Capsule and Leflunomide Tablets

CHENG Junmin; MA Zhiyi; LI Yong; WANG Gang

doi:10.13730/j.issn.1009-2595.2018.02.004

Abstract：Objective To analyze the effects of Bitongding capsule combined with leflunomide tablets on the expression of CXC chemokine receptor 4 (CXCR4) in peripheral CD4 + T lymphocytes of rheumatoid arthritis (RA) patients.Methois Sixty RA patients in Wuhan hospital of traditional Chinese medicine from April to September 2017 were selected,and divided into treatment group,control group and blank group,20 cases in each group.The treatment group was taken Bitongding capsule plus leflunomide tablets,the control group was only taken leflunomide tablets,and two groups were all under 12 weeks treatment.The blank group was initially diagnosed with RA that had not been given drugs,and the normal group selected the same period of health examinees,20 cases in each group.The clinical disease activity score 28 joints (DAS28),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) and anti cyclic citrullinated peptide antibody (anti-CCP),rheumatoid factor (RF),and other laboratory indexes in RA patients were detected.The morning fasting peripheral blood lymphocytes were separated in each group,and the proportion of CXCR4 expression in peripheral blood CD4+ T lymphocytes in RA patients was detected by flow cytometry.The proportions of CXCR4 expression in memory CD4+ T lymphocytes (CD45RO+ CD4+ T cells) of 4 groups and the relationship with the disease activities were compared and analyzed.Results The expression levels of CXCR4+ CD45ROCD4+ T lymphocytes of three RA groups were all higher than these of normal group (P＜0.05).The expressions of treatment group and control group decreased much more than these of blank group (P＜0.05).And there was difference in declined proportion between treatment group and control group (P＜0.05).The CXCR4CD45RO+ CD4+ T lymphocytes expressions were positively associated with DAS28,ESR,CRP and anti-CCP (P＜0.05),and not correlated with RF (P ＞ 0.05).Conclusion The high expression of CXCR4+ memory CD4+ T lymphocytes in peripheral blood of RA patients associate with disease activities and inflammatory biochemical indexes.The combinations of Bitongding capsule and leflunomide tablets have inhibition to the expressions of memory CXCR4+ CD4+ T lymphocytcs in RA patients.