MDS患者Treg细胞的变化

Changes of CD4＋ Treg in myelodysplastic syndromes

检测骨髓增生异常综合征（myelodysplastic syndrome MDS）患者CD4＋调节性T细胞变化，探讨其在MDS发病机制中的作用。方法以CD3和侧向角设门，采用直接免疫三标法以流式细胞术检测38例初治MDS患者（RA 17例、RAS 1例、RAEB 14例、RAEB—t 6例）及11例正常对照组外周血CD3＋ CD4＋细胞上CTLA-4、PD-1、CD25数量和比例变化，并探讨与疾病进展的关系。结果MDS组CTLA-4、PD—L1、CD25在CD3＋CD4＋表达率分别为2．14％±1．25％（RA1．51％±0．80％、RAEB／RAEB—t 2．65％±1．33％），1．44％±0．88％（RA0．93％±0．63％，RAEB／RAEB—t 2．02％±0．76％），3．18％±2．11％（RA2．80％±1．38％、RAEB／RAEB—t 3．41％±2．46％），均高于正常对照组的0．11％±0．12％，0．09%±0．14％，1．65％±1．14％（P〈0．01）。随着疾病进展，负性调控因素CTLA-4、PD—L1、CD25在RAEB／RAEB—t组亦较RA组显著增高（P〈0．01）。结论与正常人免疫系统比较，MDS患者CD4＋调节性T细胞升高，免疫负调控增强，并在免疫格局中占据主导地位。随着疾病进展，MDS患者免疫负调控亦相应增强，免疫监视功能低下，从而有助于恶性克隆扩张、逃逸。

Objective To explore the possible immune annormality CD4＋T regulatory （CD4＋ Treg） in myelodysplastic syndrome （MDS）. Methods Gated by CD3 and SSC, the changes of CTLA-4, PD-1, and CD25 on CD3＋CD4＋ cells were evaluated in 38 new diagnosed cases with MDS（RA 17, RAS 1, RAEB 14, RAEB-t 6） and 11 normal controls respectively by directive immune labels. Results In the group of MDS, CD3＋CD4＋CTLA-4＋, CD3＋CD4＋PD-1＋, and CD3＋CD4＋CD25＋ were 2. 14%±1. 25% （RA 1. 51%±0. 80%, RAEB/RAEB-t 2. 65%±1. 33%）, 1. 44%±0. 88% （RA 0. 93%±0. 63% ,RAEB/RAEB-t 2. 02%±0. 76%）, and 3. 18%±2. 11%（RA 2. 80%±1. 38%,RAEB/RAEB-t 3.41%±2.46%） in MDS, which were all higher than those of normal controls （0.11%±0.12%, 0.09%±0.14% and 1.65%±1.14% respectively） （P〈0.01）. Along with the progress of MDS, the expression of CTLA-4, PD-1 and CD25 on CD3＋CD4＋ cells increased significantly in RAEB/RAEB-t than RA. Conclusion In MDS, the negative immune CD4＋ regulatory increased, and was predominance in immune balance. Along with progression of MDS, negative regulatory factors was enforced, which promoted clone of MDS expansion.