儿童急性白血病T淋巴细胞嗜银蛋白与亚群的变化和分析

Primary study on the changes and analysis of the Ag-NORs and T lymphocyte subsets in patient with acute leukemia

目的通过对急性白血病(AL)患儿T淋巴细胞(T细胞)表示rDNA和rRNA活性的嗜银蛋白的测定,了解患儿T细胞的功能状态,并分析其与T细胞亚群之间的关系。方法应用图象分析法测定31例初发未化疗AL患儿及30例正常儿童(对照组)外周血T细胞核仁组成区嗜银蛋白(银染区)/细胞核面积(I.S%),用流式细胞仪测定T细胞亚群。结果31例AL患儿I.S%值(5.78%±2.66%)较对照组(7.51%±1.06%)下降(P<0.01)。T细胞亚群测定中,CD4+(27.50%±12.56%)较正常值(35%±2.55%)下降(P<0.05);CD8+(26.11%±12.35%)与正常值(25%±2.04%)比较差异无显著性(P>0.05);CD4+/CD8+(1.149±0.51)较正常值(2±0.26)下降(P<0.001)。结论在初发未化疗的AL患儿中,T细胞嗜银蛋白含量下降,代表患儿T细胞免疫功能的CD4+和CD4+/CD8+值降低,显示患儿T细胞活性的改变与T细胞亚群的变化相符,患儿存在T细胞免疫功能降低。

Object T lymphocytes was the major active immune competent cells in human being.Non-histone protein in nucleolar organizer regions of nucleolus was closely correlated with the prolife-ration of T lymphocytes.As non-histone protein mediated in the transcription and synthesization of rDNA and rRNA in the nucleolar organizer regions,thus the content of the non-histone protein varied with the changes of the proliferative activities of T lymphocytes.non-histone protein could be dyed with argentine and detected as well,so it is also called as argyophilic protein in nucleolar organizer regions(Ag-NORs).By measuring the changes of the quantity of Ag-NORs in T lymphocytes,the changes of the T lymphocytes activities could be found,and thus the changes of immune competency could also be known.The aim of this study was to judge the changes of the T lymphocytes competency by detecting Ag-NORs content in children with primary acute leukemia before chemotherapy,and measure the subsets such as CD3 + ,CD4 + ,and CD8 + of T lymphocytes and as well as analyze the possible relationship between them.Methods31new patients(18male,13female)with acute leukemia before chemotherapy(AL)were enrolled from August2002to December2003.They aged from0.67to15.67years,mean value8.66years.Among them,14with ALL,13with AML,and4with MAL.30normal children(18male,12female)in outpatient department were enrolled as controls.They aged from2.75to13.33years,average10.37years.Ag-NORs and CD3 + ,CD4 + ,and CD8 + of T lymphocytes were detected in peripheral blood.Argyophilic granules area of NOR/nuclear area(I.S%)of T lymphocytes were measured with imaging analysis system and T cell subsets(CD4 + and CD8 + )were studied with flow cytometry.Results I.S%in the patients(5.78%±2.66%)was significantly lower than those in the healthy donors(7.51%±1.06%)(P<0.01).The mean values of CD3 + count in the patients(57.94%±21.86%)were lower than that of the normal(70%±3.06%)(P<0.05).Significant difference in CD4 + (mainly responsible for up_regulating function)between patients(27.50%±12.56%)and the normal(35%±2.55%)was found(P<0.05).Highly significant difference in CD4 + /CD8 + ratio between patients(1.15±0.51)and the normal(2±0.26)was also observed(P<0.001).With no significant difference in CD8 + (mainlyresponsible for down-regulating)between patients(26.11%±12.35%)and the normal(25%±2.04%)(P>0.05).Conclusions These results showed the decrease of Ag-NORs contents,CD4 + and CD4 +/CD8 + ratio in T lymphocytes.Whereas the changes of Ag-NORs and subsets of T cells had close relationship,suggesting that the immune function in these patients was decreased.