TNF-α、INF-γ和EPO与肿瘤伴ACD造血功能低下的相关性

The relationship between TNF-α,INF-γ,EPO and reduced erythropoiesis in cancer with anemia of chronic disease

目的:探讨肿瘤坏死因子α(TNF-α)、干扰素γ(INF-γ)和红细胞生成素(EPO)对肿瘤伴慢性病贫血(ACD)造血功能的影响。方法:检测肿瘤患者铁代谢参数;ELISA法检测患者血清TNF-α、IFN-γ和EPO水平;观察3种细胞因子及患者血清对骨髓红系集落生成单位(CFU-E)生成的影响。结果:肿瘤伴ACD患者血清EPO水平高于正常对照,而低于IDA患者;血清TNF-α、IFN-γ水平显著升高,且与血球压积、血清铁水平负相关;TNF-α、IFN-γ可抑制正常骨髓CFU-E生成,患者血清可抑制自身骨髓CFU-E生成,rhEPO可部分纠正细胞因子对CFU-E的抑制。结论:TNFα-、IFN-γ和EPO与肿瘤伴ACD造血功能低下有关。

Aim：To investigate the effect of EPO, TNF-α and IFN-γ on erythropoiesis in cancer with anemia of chronic disease （ACD）. Methods： The iron metabolic parameters were measured by regular methods. EPO, TNF-α and IFN-γ levels in sera of cancers with ACD were detected by ELISA. The action of three cytokines and serum from patients themselves on erythroid colony forming unit-erythrocyte （CFU-E） growth of normal people＇s and patients＇ bone marrow were observed. Results： EPO levels in sera of cancers with ACD were higher than those in normal controls, while lower than those in cancers with iron-deficiency anemia. Levels of TNF-α and IFN-γ in sera of cancers with ACD were greatly increased and negatively correlated with hematocrit（Hct） and hemoglobin levels.- TNF-α and IFN-γ could inhibit normal bone marrow CFU-E growth. Bone marrow CFU-E yields of cancers with ACD could also be suppressed by their own sera. The inhibitory effects of TNF-α and IFN-γ on CFU-E growth could be partially reverted by adding rhEpo. erythropoiesis in cancer with anemia Conclusion：EPO, TNF-α and IFN-γ were associated with reduced of chronic disease.