rhG-CSF对急性白血病化疗后中性粒细胞形态、功能、表型的影响

Effect of Recombinant Human Granulocyte Colony-stimulating Factor on Neutrophil Morphorlogy, Function and Phenotype in Patients with Acute Leukemia Undergoing Chemotherapy

为了探讨急性白血病病人化疗后应用rhGCSF对中性粒细胞形态、功能及表型变化的影响,采用油镜下观察细胞形态,过氧化氢释放法、琼脂糖测定法、免疫荧光技术和流式细胞术检测中性粒细胞的吞噬、趋化及氧化代谢功能;采用免疫荧光技术和流式细胞分析检测中性粒细胞表型。结果表明:应用rhGCSF后,中性粒细胞胞浆内“中毒”颗粒数、空泡数和D¨ohle小体数增加;化疗后病人中性粒细胞吞噬、趋化及氧化代谢功能明显低于正常组,用rhGCSF后功能均增强,基本接近正常组甚至超出;用rhGCSF前中性粒细胞CD64、CD62L的表达明显高于正常对照组,用GCSF后CD64表达上调,CD62L表达显著下调;CD16、CD32、CD14和CD11b则无明显改变。结论:急性白血病病人化疗后应用rhGCSF可引起中性粒细胞形态、功能及表型出现变化,进一步增强机体的抗感染能力。

This study was to explore the effect of recombinant human granulocyte colony-stimulating factor （rhG- CSF） on neutrophil morphology, function and phenotype in patients with acute leukemia undergoing chemotherapy. Neutrophil morphology was observed under microscope with oil immersion; phagocytotic function was examined by measuring the amount of hydrogen peroxide produced by neutrophil; chemotaxis was analyzed by agarose method; oxidative burst was analyzed by flow cytometry using immunofluorescence technique; neutrophil phenotype was analyzed by flow cytometry and immunofluorescence techniques. The results showed that after rhG-CSF administration, the increased “toxic” granulation, vacuoles and Doehle bodies were observed in neutrophils of patients with acute leukemia. Compared with normal control, the functions of phagocytosis, chemotaxis, oxidative burst of neutrophil were impaired after chemotherapy, while these functions were enhanced and returned to normal level or even to be exceeded after administration of rhG-CSF. In patients with acute leukemia the neutrophil presented significantly higher expression of CD64 and CD62L than that in normal control, and a mild increase of CD64 expression and significant increase of CD62L expression were found in patients after rhG-CSF treatment. No modifications of CD16, CD32, CD14 and CD11b expression were detected in these patients before or after G-CSF administration. It is concluded that rhG-CSF administration can modify the morphology, function and phenotype of neutrophils in the patients with acute leukemia undergoing chemotherapy, and these modifications of neutrophil behavior may be supposed to be a reason for the enhancemant of organism anti-infection ability.