骨髓增生异常综合征患者CD4^+ CD25^+调节性T细胞、调控基因FOXP3的表达及意义

Expression and Significance of CD4^+ CD25^+ Treg,FOXP3 Gene in the Myelodysplastic Syndrome

目的探讨骨髓增生异常综合征(MDS)患者CD4+ CD25+调节性T细胞(CD4+ CD25+ Treg细胞)和调控基因FOXP3的表达及意义。方法分离22例MDS患者[MDS组,根据MDS分型标准分为:难治性贫血组(RA组)6例、难治性血细胞减少伴有多系发育异常组(RCMD组)11例、难治性贫血伴原始细胞增多组(RAEB组)5例]和8例正常健康者骨髓单个核细胞,采用免疫荧光标记和流式细胞仪检测CD4+ CD25+ Treg细胞占CD4+ T细胞比例;提取骨髓单个核细胞RNA,采用RT-PCR检测FOXP3基因的表达水平。结果MDS组CD4+ CD25+ Treg细胞比例、FOXP3基因表达水平与正常对照组比较,差异均无统计学意义(均P>0.05);RA组、RAEB组CD4+ CD25+ Treg细胞比例、FOXP3基因表达水平与正常对照组比较,差异均有统计学意义(均P<0.01);RCMD组CD4+ CD25+ Treg细胞比例、FOXP3基因表达水平与正常对照组比较,差异均无统计学意义(均P>0.05);RCMD组、RAEB组CD4+ CD25+ Treg细胞比例、FOXP3基因表达水平与RA组比较,差异均有统计学意义(均P<0.01);RA组、RCMD组CD4+ CD25+ Treg比例、FOXP3基因表达水平与RAEB组比较,差异均有统计学意义(均P<0.01)。结论MDS患者CD4+ CD25+ Treg占CD4+ T细胞比例及FOXP3基因表达水平随预后危险级别的升高而升高,提示免疫异常是MDS疾病的发生、发展的一个促进因素。

Objective To explore the expression levels and the clinic significance of CD4^＋CD25^＋ regulatory T cell （CD4^＋ CD25^＋ Treg cell） and regulator and control gene FOXP3 in the myelodysplastic syndrome （MDS） patients.Methods The expression levels of CD4^＋ CD25^＋ Treg was detected by means of immunofluorescence and flow cytometry in 24 patients with MDS [MDS group：divide by the standard of MDS grouping：refractory anemia group （RA group） 6 examples,refractory cytopenia with multilineage dysplasia group （RCMD group） 11 examples,refractory anemia with excess blasts group（RAEB group） 5 examples] and 8 normal controls,respectively,that of FOXP3 by real-time quantitative RT-PCR.Results The expression levels of CD4^＋ CD25^＋ Treg and FOXP3 in the MDS group were not obviously different with the normal control group（all P〈0.05）;patients with RA group and RAEB group,The expression levels of CD4^＋ CD25^＋ Treg and FOXP3 were obviously different with the normal control group （all P〈0.01）;The expression levels of CD4^＋ CD25^＋ Treg and FOXP3 in the RCMD group were not obviously different with the normal control group （all P〈0.05）;patients with RCMD group and RAEB group,The expression levels of CD4^＋ CD25^＋ Treg and FOXP3 were obviously different with the RA group（all P〈0.01）;patients with RA group and RCMD group,The expression levels of CD4^＋ CD25^＋ Treg and FOXP3 were obviously different with the RAEB group（all P〈0.01）.Conclusion The percentage of CD4^＋ CD25^＋ Treg in CD4^＋T cell and the expression level of FOXP3 depends on the risk category of MDS;higher risk indicates more percentages and expressions,suggesting that immunologic abnormality is a promoting factor in the onset and progression.