再生障碍性贫血患者免疫调节剂治疗前后TNF和IL-2水平变化及意义

CHANGES OF SERUM TNF AND IL_(-2) LEVELS IN APLASTIC ANEMIA PATIENTS BEFORE AND AFTER TREATMENT WITH IMMUNOMODULATOR

为了探讨再生障碍性贫血(AA)的免疫发病机理及抗T淋巴细胞单克隆抗体(McAb-T)的免疫调节治疗作用,采用放射免疫分析法检测30例AA患者McAb-T治疗前后血清肿瘤坏死因子(TNF)和白细胞介素-2(IL-2)水平及其中10例AA外周血单个核细胞(PBMNC)体外诱生TNF和IL-2水平的变化。结果表明,治疗前AA患者血清TNF水平显著增高(p<0.01),PBMNC诱生的TNF和IL-2水平均明显高于正常对照(p<0.01)。治疗后血清TNF和PBMNC诱生的TNF和IL-2水平降低,与对照组比较无显著差异(p>0.05)。提示AA患者存在造血调控因子分泌异常,McAb-T对TNF和IL-2能发挥特异性的免疫调节作用。

The aim of this study was to investigate the immune pathogeny and the effect of immunoregulatory therapy with monoclonal anti-human T lymphocyteantibody (McAb-T) on aplastic anemia (AA). The levels of tumor necrosis factor (TNF),interleukin-2 (IL-2) both in serum of 30 patients and in culture supernatant of peripheral blood mononuclear cells (PBMNC) in the presence of pyhtohemagglutinin(PHA)of 10 patients with AA were analysed with radio-immunoassay methods before and after McAb-T therapy. The results showed that before therapy the levels of TNF both in serum and in culture supernatant Of PBMNC were significantly higher than those in normal controls(p<0.01), IL-2 in patient serum was not much different from that in normals controls(p>0.05) but significantly increased in culture supernatant of PBMNC (p<0.01). After therapy the levels of TNF in serum and TNF or IL-2 in culture supernatant of PBMNC were decreased and not much different from normal controls (p>0.05).The abnormal production of hematopoietic regulation cytokines TNF and IL-2 might play an important role in the progression of AA patients. McAb-T could play a specific immunoregulatory role and relieve the inhibitory action, directly or indirectlv.on hematopoiesis by T lymphocytes and relative cytokines.