艾迪注射液对食管鳞癌放疗患者Th_1/Th_2转录因子和细胞因子表达的影响

Effect of Aidi Injection on Peripheral Blood Expression of Th_1/Th_2 Transcription Factors and Cytokines in Patients with Esophageal Squamous Cell Carcinoma during Radiotherapy

目的探讨艾迪注射液对食管鳞癌放疗患者Th1/Th2转录因子和细胞因子表达的影响。方法60例食管鳞癌患者随机分为放疗组和放疗加艾迪注射液组(治疗组),每组各30例,分别于治疗前后检测外周血Th1和Th2型转录因子与细胞因子的表达,同期选取20名体检健康者为健康对照组。采用实时荧光定量PCR(RQ-PCR)检测外周血单个核细胞(PBMC)中转录因子T-bet、GATA-3的表达,酶联免疫吸附法(ELISA)检测血浆中细胞因子IFN-γ、IL-2、IL-4及IL-10的表达。结果与健康对照组比较,食管鳞癌患者Th1型转录因子T-bet和细胞因子IFN-γ、IL-2的表达水平显著降低(P<0.01),Th2型转录因子GATA-3和细胞因子IL-4、IL-10的表达水平显著升高(P<0.01);与治疗前比较,放疗组治疗后T-bet、IFN-γ及IL-2的表达水平显著降低(P<0.01),GATA-3和IL-4、IL-10的表达水平显著升高(P<0.01)。治疗组治疗后T-bet、IFN-γ及IL-2的表达水平略降低,GATA-3、IL-4及IL-10的表达水平略升高,差异无统计学意义(P>0.05)。结论食管鳞癌患者体内存在Th1/Th2漂移,放疗不能逆转Th1/Th2漂移,放疗同期静脉滴注艾迪注射液能抑制Th1/Th2漂移,提高机体免疫力,同时具有放射增敏和减轻放疗不良反应的作用。

Objective To investigate the expression of Th1/Th2 transcription factors and cytokines in peripheral blood of patients with esophageal squamous cell carcinoma （ESCC） during radiotherapy to provide an evidence for using traditional Chinese medicine in anti-tumor immunotherapy. Methods Sixty patients with ESCC undergoing radiotherapy were randomly and equally assigned to the tested group （treated with combined treatment of Aidi Injection） and the control group （treated with radiotherapy alone）. A group consisted of 20 healthy persons was set up meanwhile as the normal control. Patients＇ expressions of Th1 and Th2 type transcription factors and cytokines were detected before and after radiotherapy, the expression of T-bet and GATA-3 in peripheral blood monoclear cells （PBMCs） were detected by Real-time quantitative PCR （RT-PCR）, and plasma expressions of interferon y （ IFN-γ）, interleukin 2, 4 and 10 （ IL-2, IL-4, IL-10） were detected by enzyme-linked immunosorbent assay （ELISA）. Results Compared with the healthy control group, the expressions of Th1 type transcription factor T-bet and cytokines IFN-γ, IL-2 in ESCC patients were significantly lower （ P 〈0.01 ）, while expressions of Th2 type transcription factor GATA-3 and cytokines IL-4, IL-10 were significantly higher （ P 〈0.01 ）. These changes were exacerbated significantly after radiotherapy in the control group （P 〈 0.01 ）, but only showed a slight change in the tested group with statistical insignificance （ P 〉0.05）. Conclusions Radiotherapy can not reverse the Th1/Th2 shift presented in ESCC patients, while the combined intravenous dripping of Aidi Injection during radiotherapy can inhibit it effectively. The combined therapy could elevate the immune function in organism, enhance the radiosensitivity, and attenuate the toxic-adverse effect of radiotherapy.