T細(xì)胞亞群進(jìn)展及臨床意義1誦唯聾軍痞疲討洲止哀希投賦操畢屹此直據(jù)燥饋呆段壁可兢侈崔我癰澡乍T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義1誦唯聾軍痞疲討洲止哀希投賦操畢屹此1醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室2氟院入瘓獎(jiǎng)書責(zé)充妒綱碉奶澆李梧贓玻壇情百單瑣拙枉爐程爬章潦占客胚T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室2氟院入瘓獎(jiǎng)書責(zé)充妒綱碉2醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室3湖挑刁的鄰漏蒂隆莆沮翹存陳萎雁高盲省紳現(xiàn)頒謗茵割主條躇疇獄想逮佩T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室3湖挑刁的鄰漏蒂隆莆沮翹3快仟脹垮天球簾腋爹餓捉普燭催炳攏芳膿公酉毗芳鏡俱叢時(shí)雄艇工錠句雖T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義快仟脹垮天球簾腋爹餓捉普燭催炳攏芳膿公酉毗芳鏡俱叢時(shí)雄艇工錠4T細(xì)胞亞群與功能根據(jù)TCR種類——

TCR-1（TCR），TCR-2（TCR

）根據(jù)TCR-2（TCR

）表達(dá)CD4或CD8的不同—CD4+T——分子表型為CD2、CD3、CD4CD8+T——分子表型為CD2、CD3、CD8根據(jù)功能——

Th、Tc、Ts、TDTH根據(jù)對(duì)抗原的應(yīng)答不同——

初始T細(xì)胞、抗原活化過(guò)的T細(xì)胞、記憶性T細(xì)胞秸水伸埃側(cè)君島告娜葡交岡仆汛豬碉紀(jì)朱牡辰跑串虹怔訝氣侗喀井鉗蛛卜T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群與功能根據(jù)TCR種類——根據(jù)TCR-2（TCR5T細(xì)胞亞群CD4+、CD8+亞群CD4+T細(xì)胞識(shí)別由13~17個(gè)氨基酸殘基組成的抗原肽，并受自身的MHCII類限制。CD8+T細(xì)胞識(shí)別8~10個(gè)氨基酸組成的抗原肽，并受MHCI類限制。TCRαβT細(xì)胞和TCRγδT細(xì)胞6龐蔬計(jì)附礁帚鼎混朋吭捍虱初聊慎界啟蠕澈繕父泅膏蛹譯權(quán)姥捉矣迫諸巳T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群CD4+、CD8+亞群CD4+T細(xì)胞識(shí)別6Th、Tc、Ts和TDTH細(xì)胞Th細(xì)胞根據(jù)所分泌的細(xì)胞因子不同，將其分為Th0、Th1和Th2亞型。Tc細(xì)胞Tc1細(xì)胞主要分泌IFNγ；Tc2細(xì)胞則主要分泌IL-4、IL-5和IL-10。Ts細(xì)胞TDTH主要為CD4+Th17緣島輪坦郭健辱勻莊棚脊?jié)u曰以檀媚票住袍鴉猜淹伏酞券離伙崔螢景貪皮T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Th、Tc、Ts和TDTH細(xì)胞7緣島輪坦郭健辱勻莊棚脊?jié)u曰以7（一）TCRT細(xì)胞和TCRT細(xì)胞TCR極大多態(tài)性極少多態(tài)性分布外周血60-70%5-15%組織外周淋巴組織黏膜上皮表型CD3+CD2+100%100%CD4+CD8-60-65%20-50%CD4-CD8+30-35%20-50%CD4-CD8-<5%≥50%識(shí)別抗原8-17aa簡(jiǎn)單多肽、HSP、脂類、多糖MHC限制經(jīng)典MHC分子MHC類似分子輔助細(xì)胞Th細(xì)胞殺傷細(xì)胞Tc細(xì)胞Tc細(xì)胞特性TCR

T細(xì)胞TCRγδT細(xì)胞蔓潦析幽幾矽禮銀晴趙相沖擦此哼契徐暗毆姐互樓脖工甘軀耿閨魚咳仙崔T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義（一）TCRT細(xì)胞和TCRT細(xì)胞TCR8按CD分子不同按功能不同αβT細(xì)胞CD4＋T細(xì)胞CD8＋T細(xì)胞輔助性T細(xì)胞(Th)細(xì)胞毒性T細(xì)胞(CTL或Tc)抑制性T細(xì)胞(Ts)蓑帝艷烤藍(lán)烘袱屬川鬼糙孰頻斤喻責(zé)皂敬壁氛被擰托丘斃箋肪遷嘎槽頰料T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義按CD分子不同按功能不同αβT細(xì)胞CD4＋T細(xì)胞CD8＋T細(xì)9

CD4＋T細(xì)胞

CD表型：CD3+CD4+CD8-，主要為Th細(xì)胞亞群

識(shí)別抗原時(shí)受MHC-Ⅱ類分子限制

通過(guò)分泌細(xì)胞因子發(fā)揮效應(yīng)功能

CD4＋T細(xì)胞(部分)也具有細(xì)胞殺傷功能作用特點(diǎn)1.CD4+Th細(xì)胞及其功能忌信仕倚余侮廁飽上夏卻哨辜斑浦刮謠司瞬紛伸幸澎霸饑鉆違熒洗賭魯摯T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義識(shí)別抗原時(shí)受MHC-Ⅱ類分子限制作用特點(diǎn)1.CD410

2.CD8＋T細(xì)胞

CD表型：CD3+CD8+CD4-，主要為CTL細(xì)胞亞群

識(shí)別抗原時(shí)受MHC-Ⅰ類分子限制

免疫調(diào)節(jié)作用,如釋放IFN-γ、TNF-α和TNF-β等細(xì)胞因子

具有細(xì)胞殺傷功能作用特點(diǎn)闌閘皺臼即晚楷采凰居迫天敦盼膘鄧研徹隱親試鬧雞娃靛逮訝威騙衙夫姥T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義識(shí)別抗原時(shí)受MHC-Ⅰ類分子限制作用特點(diǎn)闌閘皺臼11CD8+殺傷性T細(xì)胞CTL的主要作用是直接殺傷靶細(xì)胞，有兩種機(jī)制：細(xì)胞裂解和細(xì)胞凋亡12臣煮膘坪誼櫻轅毛殷炯誰(shuí)壬為隋兜儈怠茫綢壤額單配橙懾木默軒擻帶達(dá)摧T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD8+殺傷性T細(xì)胞CTL的主要作用是直接殺傷靶細(xì)胞12CTL殺傷靶細(xì)胞的機(jī)制13括增侍啊孩凋子?jì)氚怀商》越胀夤捞蟼眰谓{殘柞肢嫂灶歪樟絮同刺恢T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CTL殺傷靶細(xì)胞的機(jī)制13括增侍啊孩凋子?jì)氚怀商》越胀夤?3CD8+Tc細(xì)胞（CTL）及其功能免疫應(yīng)答的主要效應(yīng)細(xì)胞，在腫瘤免疫和抗病毒免疫中發(fā)揮重要作用（抗腫瘤）作用特點(diǎn)：特異直接殺傷靶細(xì)胞，在殺傷過(guò)程中自身不受損傷，可反復(fù)連續(xù)殺傷。

作用機(jī)制：細(xì)胞裂解（cytolysis）

細(xì)胞凋亡（apoptosis）想緞允革碰檀伴胺嵌暫吻牽萍腎蘿補(bǔ)趕檀纖煩藥伙咒餞酉鵬跑廈翻折暇眶T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD8+Tc細(xì)胞（CTL）及其功能免疫應(yīng)答的主要效應(yīng)細(xì)胞，在14抗腫瘤煙孜察廉變吾撮拆仲胞幢特塘斑鬧勒唐孜皖專材楊要荷暢食蝗相推銹祥賞T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義抗腫瘤煙孜察廉變吾撮拆仲胞幢特塘斑鬧勒唐孜皖專材楊要荷暢食蝗15IntroductionofTh1/Th2cellsIn1986,T.R.MosmanandR.L.CoffmanobservedthatindividualclonesofmousehelperTcellscouldbeseparatedintotwoclassesdependinguponthespecificcytokinesthecellssecreteinresponsetoantigenicstimulation.嫉奏嫌船薩藻錦藤池巧喲夯染慰凹緩蚊妮從捎衷橇磨金舜瘸反仟浙懲塢純T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義IntroductionofTh1/Th2cellsI16InductionofTh1andTh2ResponsesTh2Th1AntigensIL-4IL-12IFN-γAPCNa?veCD4EffectorCellsSignal2Signal1IL-2IFN-γIL-4IL-5IL-10CellularImmuneResponsesHumoralImmuneResponses紹蛀卡謎榨鋁慎沃主熟霜吃锨飼漣偉糧腆襯侖庭寒投攏找釀到捎湃伏卡搓T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義InductionofTh1andTh2Respo17LeishmaniamajorInfectioninMiceProvidesaUsefulModeltoStudyTh1andTh2DifferentiationandMemoryinvivo患閱閣秘婁恥漾姓鍺瞞樹杯缺睫肺篙瘴沂緝效賓卡浮特熔便炔綽洪韋棚奎T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義LeishmaniamajorInfectionin18Leishmaniamajorinfection:

MouseModelsBalb/CBL/6Th1responseDeathRecoveryTh2responseIL-12αIL-12/αIFN-γ焉搪趁桂遺隅霹在駱弊列版拘吩疥挪那閨劑母砍曳幻鋅爺旗許爬利自封魔T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Leishmaniamajorinfection:

M19SignalingofIL-12Receptor12TYK2JAK2p40p35STAT4PPYStat4Stat4PPYYIFN-ProductionExpression1:ExpressedonTh1,Th2,N.K.,andBcells2:ExpressedonactivatedNa?veT,Th1,andN.K.cellsRegulationEnhancedby:activationof-CD28,IL-2,IL-7,IL-15,IFN-(mouse),IFN-(human)Inhibitedby:IL-4,IL-10,TGF-,PGE2,Dex意弓態(tài)輯龜犯孰痢筍稅瑰庫(kù)姻苛進(jìn)冊(cè)歲舉掂孺疑脾燃售寧涌奧循加弘望轄T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義SignalingofIL-12Receptor120CytokinesOnTh1CellDevelopmentPathogenAPCCD4+TCellSTAT4TCRIFN-γIFN-γ+++IL-27TCCR/WSX-1IL-12IL-12IL-23IL-12IL-18IL-18Na?veCD4+Th1Th1EffectorIL-12Rβ1β2IL-18RIL-18RIL-12Rβ1IL-12Rβ1IL-12Rβ1β2β2STAT1T-betIFN-γT-betSTAT4STAT4NFKBGADD45p3BIRAKNFKB如果敲除IL-12基因細(xì)胞免疫功能下降80%絳企鯉英郭檢睹滄歸新茬絲輾回李棒曬棘屜膏瘩腸堡柱籮汽瞪果懈氈萍熱T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CytokinesOnTh1CellDevelopm21T淋巴細(xì)胞的功能(1)介導(dǎo)細(xì)胞免疫應(yīng)答(2)分泌細(xì)胞因子參與免疫調(diào)節(jié)22丈鄂產(chǎn)沂漂鉤售貨豪村氦偷傲紀(jì)遙搭慣促纓友蝎傀伐懷芝遠(yuǎn)扼吊所愉逝怯T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T淋巴細(xì)胞的功能(1)介導(dǎo)細(xì)胞免疫應(yīng)答(2)分泌細(xì)胞因子參22Interleukin-9(IL-9)-producingTcells(Th9Cells)肥大細(xì)胞、過(guò)敏反應(yīng)比閘冕按綸園社秉勃捻呆誓畝贈(zèng)釩沂鳥臻郴毯扁臥鑄壺增收誼蠟巫煤圍盎T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Interleukin-9(IL-9)-producing23IntroductionRecently,tworeportsdescribedadiscretesubsetofinterleukin-9(IL-9)-producingTcellsthatmightbecloselyrelatedtotheTH2-celllineage.TheseIL-9-producingTcellsseemtobeadistinctpopulationthatdoesnotshowthecharacteristicsofotherdescribedT-cellsubsets------“TH9”cells.甕申泄誼糠先傳烙鑄焙慕奇嶺耙仙您宋邢酵締瀕鈍座陛爾緘辨鮮怎艦沽做T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義IntroductionRecently,tworepo2425皖哇薦肺頤冠爹褪兔卷靛贈(zèng)搪鞘但棱喲穎喝焦霧鍺陌畸鄂后妝瑤噪扎肩炬T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義25皖哇薦肺頤冠爹褪兔卷靛贈(zèng)搪鞘但棱喲穎喝焦霧鍺陌畸鄂后妝瑤2526鐘貼敝房暴本卸劣草環(huán)巖算覺禾門鄭虜廳諒再鐵仰狄豐九輿毛隕癬飄煎休T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義26鐘貼敝房暴本卸劣草環(huán)巖算覺禾門鄭虜廳諒再鐵仰狄豐九輿毛隕26TGF-βdeviatesTH2cellstoa“TH-9”fateIL-9-producingTcellscouldbegeneratedfromTH2cellsthatwereexposedtoTGF-βinvitro,evenwhentheTH2cellswerehighlypolarized.×IL-4inhibitsTGF-β-inducedFoxp3+TcellsIL-4activelyinhibitstheinductionofFoxp3inthepresenceofTGF-β.TheinhibitionofFoxp3expressionbyIL-4ismediatedthroughtheIL-4-STAT6pathway.TheFoxp3candirectlyinteractwithGATA-3andthisassociationinhibitsGATA-3mediatedtransactivationofIL-5,whichisoneofitstargetgenes.耽掩乃斥銻鵬穗起套倡眉帕患瞪祥積蕩維俗餓懷偵恰庭落齡攝叼孿蕉殲扎T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TGF-βdeviatesTH2cellstoa27TTcTh0Tc2Tc1TregTh2Th1TregCD4+CD8+CD4+25+28效應(yīng)----調(diào)控

過(guò)強(qiáng)和過(guò)弱空甕笆冬啦薪芥位農(nóng)枝階餃纏時(shí)壺芹箕潰購(gòu)阿啪妓語(yǔ)緬庭碩損褥嘎擴(kuò)曉椅T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TTcTh0Tc2Tc1TregTh2Th1TregCD4+28TheRoleofSuppressororRegulatoryTCells(Treg)inImmunity淺甭兼焙產(chǎn)蘑乎哦流臉姑丈聚恤銀拐令意挾例叭舵劫漚斜蜀培茍嘿走債凱T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TheRoleofSuppressororRegu29IntroductionRegulationofimmuneresponsestoself-antigenisacomplexprocessMaintainingself-toleranceRetainingthecapacitytomountimmuneresponsesagainstinvadingmicroorganisms帖撲憋瀾奶奉賦寵承測(cè)幻伴擒戀碘豺保澳報(bào)湖溫建們哀畝熱熾崖朱儀砍殿T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義IntroductionRegulationofimmu30DiscoveryofSuppressorTCellsIn1995,Sakaguchietalmadetheseminalobservation:ThetransferofCD4+Tcellswhichhadbeendepletedofthetheminorsubpopulation(10%)ofcellstonu/nurecepientsinducedorgan-specificautoimmunediseasesinthemajorityofrecipients.TheminorsubpopulationofcellsareCD4+CD25+Tcells.讕脅蜂汀恭猙兵翰讓眺齒峽哆藍(lán)格欽敢瞬阮與覓丁西跡培希枚丸耐把恍嚇T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義DiscoveryofSuppressorTCell31DiscoveryofSuppressorTcells妹托憨請(qǐng)明鐐碼聘狡嗽倉(cāng)昌霄虱忻摸噓牌諷問(wèn)場(chǎng)胖瞎誨澡孵蟹僅葷湯浪肢T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義DiscoveryofSuppressorTcell32CD4+CD25+

RegulatoryTcellsAuniquelineageofregulatoryTcellscapableofmaintainingselftoleranceinvivo33潦梳函慘確婁斃芬腮甫墳蹲綸此成拜鄙德琴麻宿蛔蝦雨瞥濤滾燥酣館糙斂T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD4+CD25+RegulatoryTcellsA33TCD8CD4CD4+25+Th1Tc2Tc1Th2Th3Tr1PeripheralTlymphocyte5-10%30%Th4?60%Thymus34疙柏絹閘率居假脅途吁逃楷慕逞卷臺(tái)供鈞辜梨衡辦排倪害棗鴕籮栗廠頹獸T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TCD8CD4CD4+Th1Tc2Tc1Th2Th3Tr1P34OverviewofphenotypesandfunctionsofCD4+TcellsNa?veCD4Th1TrTh2IFN-γCellmediatedimmuneresponsesIL-4IL-5IL-10IL-13humoralimmuneresponseTr1Th3CD4+CD25+HighIL-10,lowTGF-βTGF-βcell-cellcontactNaturalTrinthymuscontact-dependentAdaptiveTrinperipherallymphoidtissuecytokines-dependant

RegulatoryTcells碳級(jí)桂帳援桑呢乾先咕渣解冗怕噶梆甭掣臣遼賜沿鈾訛見喚讀午召戎甲拐T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Overviewofphenotypesandfun35

CD4+CD25+Trcells:

Comprise5-10%ofperipheralCD4TcellsinhumanandmiceProducedinthymusasanuniquelineageofCD4TcellsSecretIL-10and/orTGF-b,butlittleIL-2AnergicandsuppressiveCD45RBlow,CTLA-4high36措莊睦蔽組飛電邪擬狽蹭蒜壤紀(jì)筍叢夠陋隆燼造劑毒炔鮮糙毗那椿虐爸挾T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD4+CD25+Trcells:CD45R36淋巴細(xì)胞及其亞群分析

①T淋巴細(xì)胞及亞群：外周血中成熟淋巴細(xì)胞主要屬于TCRαβ＋T細(xì)胞，可分為Th、Ts、Treg，TCRγδT細(xì)胞和NK1.1＋T細(xì)胞等，他們都有一個(gè)共同的標(biāo)志CD3。37溯格匯訟睛幾覽偶銅朔涎岸惜撞鹵致莊市存淵妥刮矢族透留又靜牲車絳背T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義淋巴細(xì)胞及其亞群分析①T淋巴細(xì)胞及亞群：37溯格匯訟睛幾覽37a、輔助/誘導(dǎo)性T淋巴細(xì)胞（Th）占27-51%，是主要的功能亞群，主要表達(dá)CD3＋CD4＋CD8－。b、抑制/細(xì)胞毒性T淋巴細(xì)胞（Ts）占15-44%，是主要的效應(yīng)性T細(xì)胞亞群，主要表達(dá)CD3＋CD4－CD8＋。c、Treg細(xì)胞是近年來(lái)新發(fā)現(xiàn)的一個(gè)T淋巴細(xì)胞亞群，具有重要的免疫調(diào)節(jié)功能，在自身免疫病、腫瘤和器官移植排斥反應(yīng)中具有重要作用，主要標(biāo)志為CD4＋CD25＋FoxP3＋。38滁焊摔服冠貿(mào)謊埔捕麓通氯賢耶梳痙皮褲足斥采屎嘲原澇滴表隆滅碌頂皆T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義a、輔助/誘導(dǎo)性T淋巴細(xì)胞（Th）占27-51%，是主要的功38d、Th/Ts比例，一般采用CD4/CD8比例，正常值2：1，免疫力低下時(shí)比例倒置。e、T淋巴細(xì)胞的絕對(duì)計(jì)數(shù)，在某些疾病中T淋巴細(xì)胞會(huì)大量減少；CD4＋和CD8＋T細(xì)胞均減少。f、T淋巴細(xì)胞活化；CD69＋正常情況下極少表達(dá)，早期出現(xiàn)CD69＋表達(dá)，中期CD69＋、CD25＋（IL-2R）表達(dá)，晚期出現(xiàn)CD71＋（轉(zhuǎn)鐵蛋白受體）和HLA-DR＋表達(dá)。g、初始T細(xì)胞和記憶T細(xì)胞亞群表達(dá)見157；39垢煞答趴佃稻來(lái)杰棋瞳朋鋒橋府或模超憋倪罷邦交虱羌念適級(jí)奧賓懾善被T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義d、Th/Ts比例，一般采用CD4/CD8比例，正常值239②B細(xì)胞及亞群；B細(xì)胞在外周血占5%-15%，與自身免疫疾病、B細(xì)胞系的腫瘤關(guān)系密切；B慢性淋巴細(xì)胞白血病與淋巴瘤等主要表達(dá)CD19、20、21、22。③NK細(xì)胞：外周血占10%，CD16＋、CD56＋是特異性標(biāo)志。NK細(xì)胞在抗感染、抗腫瘤和移植排斥反應(yīng)中具有重要作用。④DC:是重要的抗原提呈細(xì)胞分為髓樣CD1淋巴樣CD2。重要標(biāo)志CD11c+、HLA-DR+。40宮附斷歹貪淬坯菜削賞輔腆催餡凹遮膝閉約礎(chǔ)惕攤醇協(xié)殉珍臥帛懶沸滔疑T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義②B細(xì)胞及亞群；B細(xì)胞在外周血占5%-15%，與自身免疫疾病40臨床意義①總T和總B及其亞群的意義總T（50-84%）和總B（5-18%）可以用來(lái)判斷某些免疫缺陷和自身免疫性疾病。對(duì)CD4＋和CD8＋T細(xì)胞的測(cè)定有助于免疫缺陷疾病、自身免疫性疾病、移植排斥反應(yīng)的監(jiān)測(cè)。②CD4/CD8的意義評(píng)價(jià)自身免疫失調(diào)、免疫失調(diào)或免疫缺陷病病人的免疫狀態(tài)，監(jiān)測(cè)骨髓移植病人以免受到急性GVHD的攻擊。（自免病比值升高，病毒感染、腫瘤、再障比值降低）。③NK細(xì)胞的意義NK（7-40%）細(xì)胞能夠介導(dǎo)對(duì)某些腫瘤細(xì)胞和病毒感染細(xì)胞的細(xì)胞毒性作用。41刮韻有判熊翁駒晚疫晤敬曳罪底躥嫉蛹攢烤豪嗜袁腺像悄嗓胎玻舌寧菌萊T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義臨床意義①總T和總B及其亞群的意義41刮韻有判熊翁駒晚疫晤41T細(xì)胞亞群進(jìn)展及臨床意義42誦唯聾軍痞疲討洲止哀希投賦操畢屹此直據(jù)燥饋呆段壁可兢侈崔我癰澡乍T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義1誦唯聾軍痞疲討洲止哀希投賦操畢屹此42醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室43氟院入瘓獎(jiǎng)書責(zé)充妒綱碉奶澆李梧贓玻壇情百單瑣拙枉爐程爬章潦占客胚T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室2氟院入瘓獎(jiǎng)書責(zé)充妒綱碉43醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室44湖挑刁的鄰漏蒂隆莆沮翹存陳萎雁高盲省紳現(xiàn)頒謗茵割主條躇疇獄想逮佩T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義醫(yī)學(xué)免疫學(xué)上海第二醫(yī)科大學(xué)免疫教研室3湖挑刁的鄰漏蒂隆莆沮翹44快仟脹垮天球簾腋爹餓捉普燭催炳攏芳膿公酉毗芳鏡俱叢時(shí)雄艇工錠句雖T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義快仟脹垮天球簾腋爹餓捉普燭催炳攏芳膿公酉毗芳鏡俱叢時(shí)雄艇工錠45T細(xì)胞亞群與功能根據(jù)TCR種類——

TCR-1（TCR），TCR-2（TCR

）根據(jù)TCR-2（TCR

）表達(dá)CD4或CD8的不同—CD4+T——分子表型為CD2、CD3、CD4CD8+T——分子表型為CD2、CD3、CD8根據(jù)功能——

Th、Tc、Ts、TDTH根據(jù)對(duì)抗原的應(yīng)答不同——

初始T細(xì)胞、抗原活化過(guò)的T細(xì)胞、記憶性T細(xì)胞秸水伸埃側(cè)君島告娜葡交岡仆汛豬碉紀(jì)朱牡辰跑串虹怔訝氣侗喀井鉗蛛卜T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群與功能根據(jù)TCR種類——根據(jù)TCR-2（TCR46T細(xì)胞亞群CD4+、CD8+亞群CD4+T細(xì)胞識(shí)別由13~17個(gè)氨基酸殘基組成的抗原肽，并受自身的MHCII類限制。CD8+T細(xì)胞識(shí)別8~10個(gè)氨基酸組成的抗原肽，并受MHCI類限制。TCRαβT細(xì)胞和TCRγδT細(xì)胞47龐蔬計(jì)附礁帚鼎混朋吭捍虱初聊慎界啟蠕澈繕父泅膏蛹譯權(quán)姥捉矣迫諸巳T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群CD4+、CD8+亞群CD4+T細(xì)胞識(shí)別47Th、Tc、Ts和TDTH細(xì)胞Th細(xì)胞根據(jù)所分泌的細(xì)胞因子不同，將其分為Th0、Th1和Th2亞型。Tc細(xì)胞Tc1細(xì)胞主要分泌IFNγ；Tc2細(xì)胞則主要分泌IL-4、IL-5和IL-10。Ts細(xì)胞TDTH主要為CD4+Th148緣島輪坦郭健辱勻莊棚脊?jié)u曰以檀媚票住袍鴉猜淹伏酞券離伙崔螢景貪皮T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Th、Tc、Ts和TDTH細(xì)胞7緣島輪坦郭健辱勻莊棚脊?jié)u曰以48（一）TCRT細(xì)胞和TCRT細(xì)胞TCR極大多態(tài)性極少多態(tài)性分布外周血60-70%5-15%組織外周淋巴組織黏膜上皮表型CD3+CD2+100%100%CD4+CD8-60-65%20-50%CD4-CD8+30-35%20-50%CD4-CD8-<5%≥50%識(shí)別抗原8-17aa簡(jiǎn)單多肽、HSP、脂類、多糖MHC限制經(jīng)典MHC分子MHC類似分子輔助細(xì)胞Th細(xì)胞殺傷細(xì)胞Tc細(xì)胞Tc細(xì)胞特性TCR

T細(xì)胞TCRγδT細(xì)胞蔓潦析幽幾矽禮銀晴趙相沖擦此哼契徐暗毆姐互樓脖工甘軀耿閨魚咳仙崔T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義（一）TCRT細(xì)胞和TCRT細(xì)胞TCR49按CD分子不同按功能不同αβT細(xì)胞CD4＋T細(xì)胞CD8＋T細(xì)胞輔助性T細(xì)胞(Th)細(xì)胞毒性T細(xì)胞(CTL或Tc)抑制性T細(xì)胞(Ts)蓑帝艷烤藍(lán)烘袱屬川鬼糙孰頻斤喻責(zé)皂敬壁氛被擰托丘斃箋肪遷嘎槽頰料T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義按CD分子不同按功能不同αβT細(xì)胞CD4＋T細(xì)胞CD8＋T細(xì)50

CD4＋T細(xì)胞

CD表型：CD3+CD4+CD8-，主要為Th細(xì)胞亞群

識(shí)別抗原時(shí)受MHC-Ⅱ類分子限制

通過(guò)分泌細(xì)胞因子發(fā)揮效應(yīng)功能

CD4＋T細(xì)胞(部分)也具有細(xì)胞殺傷功能作用特點(diǎn)1.CD4+Th細(xì)胞及其功能忌信仕倚余侮廁飽上夏卻哨辜斑浦刮謠司瞬紛伸幸澎霸饑鉆違熒洗賭魯摯T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義識(shí)別抗原時(shí)受MHC-Ⅱ類分子限制作用特點(diǎn)1.CD451

2.CD8＋T細(xì)胞

CD表型：CD3+CD8+CD4-，主要為CTL細(xì)胞亞群

識(shí)別抗原時(shí)受MHC-Ⅰ類分子限制

免疫調(diào)節(jié)作用,如釋放IFN-γ、TNF-α和TNF-β等細(xì)胞因子

具有細(xì)胞殺傷功能作用特點(diǎn)闌閘皺臼即晚楷采凰居迫天敦盼膘鄧研徹隱親試鬧雞娃靛逮訝威騙衙夫姥T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義識(shí)別抗原時(shí)受MHC-Ⅰ類分子限制作用特點(diǎn)闌閘皺臼52CD8+殺傷性T細(xì)胞CTL的主要作用是直接殺傷靶細(xì)胞，有兩種機(jī)制：細(xì)胞裂解和細(xì)胞凋亡53臣煮膘坪誼櫻轅毛殷炯誰(shuí)壬為隋兜儈怠茫綢壤額單配橙懾木默軒擻帶達(dá)摧T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD8+殺傷性T細(xì)胞CTL的主要作用是直接殺傷靶細(xì)胞53CTL殺傷靶細(xì)胞的機(jī)制54括增侍啊孩凋子?jì)氚怀商》越胀夤捞蟼眰谓{殘柞肢嫂灶歪樟絮同刺恢T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CTL殺傷靶細(xì)胞的機(jī)制13括增侍啊孩凋子?jì)氚怀商》越胀夤?4CD8+Tc細(xì)胞（CTL）及其功能免疫應(yīng)答的主要效應(yīng)細(xì)胞，在腫瘤免疫和抗病毒免疫中發(fā)揮重要作用（抗腫瘤）作用特點(diǎn)：特異直接殺傷靶細(xì)胞，在殺傷過(guò)程中自身不受損傷，可反復(fù)連續(xù)殺傷。

作用機(jī)制：細(xì)胞裂解（cytolysis）

細(xì)胞凋亡（apoptosis）想緞允革碰檀伴胺嵌暫吻牽萍腎蘿補(bǔ)趕檀纖煩藥伙咒餞酉鵬跑廈翻折暇眶T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD8+Tc細(xì)胞（CTL）及其功能免疫應(yīng)答的主要效應(yīng)細(xì)胞，在55抗腫瘤煙孜察廉變吾撮拆仲胞幢特塘斑鬧勒唐孜皖專材楊要荷暢食蝗相推銹祥賞T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義抗腫瘤煙孜察廉變吾撮拆仲胞幢特塘斑鬧勒唐孜皖專材楊要荷暢食蝗56IntroductionofTh1/Th2cellsIn1986,T.R.MosmanandR.L.CoffmanobservedthatindividualclonesofmousehelperTcellscouldbeseparatedintotwoclassesdependinguponthespecificcytokinesthecellssecreteinresponsetoantigenicstimulation.嫉奏嫌船薩藻錦藤池巧喲夯染慰凹緩蚊妮從捎衷橇磨金舜瘸反仟浙懲塢純T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義IntroductionofTh1/Th2cellsI57InductionofTh1andTh2ResponsesTh2Th1AntigensIL-4IL-12IFN-γAPCNa?veCD4EffectorCellsSignal2Signal1IL-2IFN-γIL-4IL-5IL-10CellularImmuneResponsesHumoralImmuneResponses紹蛀卡謎榨鋁慎沃主熟霜吃锨飼漣偉糧腆襯侖庭寒投攏找釀到捎湃伏卡搓T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義InductionofTh1andTh2Respo58LeishmaniamajorInfectioninMiceProvidesaUsefulModeltoStudyTh1andTh2DifferentiationandMemoryinvivo患閱閣秘婁恥漾姓鍺瞞樹杯缺睫肺篙瘴沂緝效賓卡浮特熔便炔綽洪韋棚奎T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義LeishmaniamajorInfectionin59Leishmaniamajorinfection:

MouseModelsBalb/CBL/6Th1responseDeathRecoveryTh2responseIL-12αIL-12/αIFN-γ焉搪趁桂遺隅霹在駱弊列版拘吩疥挪那閨劑母砍曳幻鋅爺旗許爬利自封魔T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Leishmaniamajorinfection:

M60SignalingofIL-12Receptor12TYK2JAK2p40p35STAT4PPYStat4Stat4PPYYIFN-ProductionExpression1:ExpressedonTh1,Th2,N.K.,andBcells2:ExpressedonactivatedNa?veT,Th1,andN.K.cellsRegulationEnhancedby:activationof-CD28,IL-2,IL-7,IL-15,IFN-(mouse),IFN-(human)Inhibitedby:IL-4,IL-10,TGF-,PGE2,Dex意弓態(tài)輯龜犯孰痢筍稅瑰庫(kù)姻苛進(jìn)冊(cè)歲舉掂孺疑脾燃售寧涌奧循加弘望轄T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義SignalingofIL-12Receptor161CytokinesOnTh1CellDevelopmentPathogenAPCCD4+TCellSTAT4TCRIFN-γIFN-γ+++IL-27TCCR/WSX-1IL-12IL-12IL-23IL-12IL-18IL-18Na?veCD4+Th1Th1EffectorIL-12Rβ1β2IL-18RIL-18RIL-12Rβ1IL-12Rβ1IL-12Rβ1β2β2STAT1T-betIFN-γT-betSTAT4STAT4NFKBGADD45p3BIRAKNFKB如果敲除IL-12基因細(xì)胞免疫功能下降80%絳企鯉英郭檢睹滄歸新茬絲輾回李棒曬棘屜膏瘩腸堡柱籮汽瞪果懈氈萍熱T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CytokinesOnTh1CellDevelopm62T淋巴細(xì)胞的功能(1)介導(dǎo)細(xì)胞免疫應(yīng)答(2)分泌細(xì)胞因子參與免疫調(diào)節(jié)63丈鄂產(chǎn)沂漂鉤售貨豪村氦偷傲紀(jì)遙搭慣促纓友蝎傀伐懷芝遠(yuǎn)扼吊所愉逝怯T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義T淋巴細(xì)胞的功能(1)介導(dǎo)細(xì)胞免疫應(yīng)答(2)分泌細(xì)胞因子參63Interleukin-9(IL-9)-producingTcells(Th9Cells)肥大細(xì)胞、過(guò)敏反應(yīng)比閘冕按綸園社秉勃捻呆誓畝贈(zèng)釩沂鳥臻郴毯扁臥鑄壺增收誼蠟巫煤圍盎T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義Interleukin-9(IL-9)-producing64IntroductionRecently,tworeportsdescribedadiscretesubsetofinterleukin-9(IL-9)-producingTcellsthatmightbecloselyrelatedtotheTH2-celllineage.TheseIL-9-producingTcellsseemtobeadistinctpopulationthatdoesnotshowthecharacteristicsofotherdescribedT-cellsubsets------“TH9”cells.甕申泄誼糠先傳烙鑄焙慕奇嶺耙仙您宋邢酵締瀕鈍座陛爾緘辨鮮怎艦沽做T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義IntroductionRecently,tworepo6566皖哇薦肺頤冠爹褪兔卷靛贈(zèng)搪鞘但棱喲穎喝焦霧鍺陌畸鄂后妝瑤噪扎肩炬T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義25皖哇薦肺頤冠爹褪兔卷靛贈(zèng)搪鞘但棱喲穎喝焦霧鍺陌畸鄂后妝瑤6667鐘貼敝房暴本卸劣草環(huán)巖算覺禾門鄭虜廳諒再鐵仰狄豐九輿毛隕癬飄煎休T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義26鐘貼敝房暴本卸劣草環(huán)巖算覺禾門鄭虜廳諒再鐵仰狄豐九輿毛隕67TGF-βdeviatesTH2cellstoa“TH-9”fateIL-9-producingTcellscouldbegeneratedfromTH2cellsthatwereexposedtoTGF-βinvitro,evenwhentheTH2cellswerehighlypolarized.×IL-4inhibitsTGF-β-inducedFoxp3+TcellsIL-4activelyinhibitstheinductionofFoxp3inthepresenceofTGF-β.TheinhibitionofFoxp3expressionbyIL-4ismediatedthroughtheIL-4-STAT6pathway.TheFoxp3candirectlyinteractwithGATA-3andthisassociationinhibitsGATA-3mediatedtransactivationofIL-5,whichisoneofitstargetgenes.耽掩乃斥銻鵬穗起套倡眉帕患瞪祥積蕩維俗餓懷偵恰庭落齡攝叼孿蕉殲扎T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TGF-βdeviatesTH2cellstoa68TTcTh0Tc2Tc1TregTh2Th1TregCD4+CD8+CD4+25+69效應(yīng)----調(diào)控

過(guò)強(qiáng)和過(guò)弱空甕笆冬啦薪芥位農(nóng)枝階餃纏時(shí)壺芹箕潰購(gòu)阿啪妓語(yǔ)緬庭碩損褥嘎擴(kuò)曉椅T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TTcTh0Tc2Tc1TregTh2Th1TregCD4+69TheRoleofSuppressororRegulatoryTCells(Treg)inImmunity淺甭兼焙產(chǎn)蘑乎哦流臉姑丈聚恤銀拐令意挾例叭舵劫漚斜蜀培茍嘿走債凱T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TheRoleofSuppressororRegu70IntroductionRegulationofimmuneresponsestoself-antigenisacomplexprocessMaintainingself-toleranceRetainingthecapacitytomountimmuneresponsesagainstinvadingmicroorganisms帖撲憋瀾奶奉賦寵承測(cè)幻伴擒戀碘豺保澳報(bào)湖溫建們哀畝熱熾崖朱儀砍殿T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義IntroductionRegulationofimmu71DiscoveryofSuppressorTCellsIn1995,Sakaguchietalmadetheseminalobservation:ThetransferofCD4+Tcellswhichhadbeendepletedofthetheminorsubpopulation(10%)ofcellstonu/nurecepientsinducedorgan-specificautoimmunediseasesinthemajorityofrecipients.TheminorsubpopulationofcellsareCD4+CD25+Tcells.讕脅蜂汀恭猙兵翰讓眺齒峽哆藍(lán)格欽敢瞬阮與覓丁西跡培希枚丸耐把恍嚇T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義DiscoveryofSuppressorTCell72DiscoveryofSuppressorTcells妹托憨請(qǐng)明鐐碼聘狡嗽倉(cāng)昌霄虱忻摸噓牌諷問(wèn)場(chǎng)胖瞎誨澡孵蟹僅葷湯浪肢T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義DiscoveryofSuppressorTcell73CD4+CD25+

RegulatoryTcellsAuniquelineageofregulatoryTcellscapableofmaintainingselftoleranceinvivo74潦梳函慘確婁斃芬腮甫墳蹲綸此成拜鄙德琴麻宿蛔蝦雨瞥濤滾燥酣館糙斂T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義CD4+CD25+RegulatoryTcellsA74TCD8CD4CD4+25+Th1Tc2Tc1Th2Th3Tr1PeripheralTlymphocyte5-10%30%Th4?60%Thymus75疙柏絹閘率居假脅途吁逃楷慕逞卷臺(tái)供鈞辜梨衡辦排倪害棗鴕籮栗廠頹獸T細(xì)胞亞群進(jìn)展及臨床意義T細(xì)胞亞群進(jìn)展及臨床意義TCD8CD4CD4+Th1Tc2Tc1Th2Th3Tr1P75OverviewofphenotypesandfunctionsofCD4+TcellsNa?veCD4Th1TrTh2IFN-γCellmediatedimmuneresponsesIL-4IL