细胞免疫紊乱对骨髓增生异常综合征病情进展影响的初步研究

Preliminary study on effect of cellar immunity disturbance on disease progression of myeloplastic sydrome

目的:研究比较不同组骨髓增生异常综合征(MDS)患者及健康人之间T细胞亚群、T辅助细胞亚群、细胞因子浓度差异,探讨细胞免疫功能紊乱对MDS病情进展的影响。方法:选择MDS患者32例及健康对照5例,按IPSS积分其中低危组10例、中危-1组8例,中危-2组8例,高危组6例,取其骨髓流式细胞仪测定T细胞亚群、T辅助细胞亚群,酶联免疫吸附试验(ELISA)测定干扰素(IFN)-γ、白细胞介素(IL)-2浓度。结果:低危组、中危-1组细胞毒性T细胞(CTLs)、Th1、Th1/Th2高于中危-2组、高危组、健康对照组且有统计学意义(P<0.05),低危组、中危-1组之间,中危-2组、高危组、健康对照组之间CTLs、Th1、Th1/Th2差异无统计学意义(P>0.05)。随着CTLs、Th1逐渐下降,MDS患者骨髓原始细胞比例逐渐增高,呈负相关。各组之间IFN-γ、IL-2浓度差异无统计学意义,但低危组、中危-1组较中危-2组、高危组、健康对照组细胞因子浓度有增高趋势。结论:在MDS的发生、发展过程中,细胞免疫功能发生紊乱,即低危组、中危-1组CTLs、Th1、Th1/Th2较中危-2组、高危组增高,可能与MDS病情进展有关。

Objective：To study and compare T lymphocyte subsets, T assistant lymphocyte subsets and levels of cytokines among several subgroups of myeloplastic sydrome（MDS） patients and healthy controls,and to investigate the effect of cellar immunity disturbance on disease progression of MDS. Method： 32 patients with MDS and 5 normal individuals were selected. According international prognostic scoring system（IPSS）, MDS patients were divided into four groups with different risk level： low, intermediate-1 （int-1）, intermediate-2 （int-2） and high, and the patients＇ number was 10,8,8,6 respectively. T lymphocyte subsets and T assistant lymphocyte subsets in the bone marrow were detected by FACS,and enzymelinked immunosorbentassy（ELISA） was used to measured the levels of interferon-γ（IFN-γ） and interleukin-2 （IL-2）. Results：The quantity of cytotoxic T cells（CTLs） ,Thl cells and ratio of Th1/Th2 of low risk group and int-1 risk group were significantly higher than that of int-2 risk group, high risk group and healthy controls. There were no significant differences of quantity of CTLs,Th1 cells and ratio of Th1/Th2 between low risk group and int-1 risk group,so were among int-2 risk group,high risk group and normal controls. The lower quantity of CTLs,Th1 was negatitively correlated with the higher percentage of blast cells in the bone marrow of MDS patients. No statistical difference of concentration of IFN-γ and IL-2 was found among the groups,but concentration of IFN-γ and IL-2 of low and int-1 group was higher than that of int-2 risk group, high risk group and normal controls. Conclusion： During the initiation and evolution of MDS, the cellar immune function is abnormal： the quantity of CTLs,Th1 cells and ratio of Thγ/Th2 of low risk group and int 1 risk group were markedly higher than that of int-2 risk group,high risk group. This may he related to disease progression of MDS.