利妥昔单抗治疗前后弥漫大B细胞淋巴瘤患者Th17细胞及相关细胞因子的变化

Changes of Th17 cells and related cytokines in diffuse large B-cell lymphoma patients before and after treated with rituximab

目的了解弥漫大B细胞淋巴瘤（DLBCL）患者接受利妥昔单抗治疗前后Th17细胞及相关细胞因子的变化及其意义。方法初治患者31例，化疗后患者60例（RCHOP组29例、CHOP组31例），以20名体检健康者为健康对照组。采用流式细胞术检测各组外周血中Th17细胞比例，酶联免疫吸附法检测外周血相关细胞因子白细胞介素17（IL-17）、IL-21、IL-23、转化生长因子β（TGF—β）的表达水平。结果初治组和CHOP．完全缓解（CR）组Th17细胞比例、IL-17、IL-21、IL．23水平分别为（0．67±0．21）％、（5．929±1．342）Pg／ml、（130．632±17．945）Pg／ml、（51．681±9．808）Pg／ml和（1．07±0．37）％、（6．526±0．538）Pg／ml、（132．119±7．700）Pg／ml、（50．245±7．668）Pg／ml，均低于对照组的（2．53±0．63）％、（8．435±2．031）Pg／ml、（149．265±12．316）Pg／ml、（55．303±7．778）Pg／ml（P〈0．05）；初治组TGF—β水平为（370．615±98．444）Pg／ml，显著高于对照组的（311．895±73．365）Dg／ml（P〈0．05）。RCHOP—CR组Th17细胞比例、IL．17、IL-21、IL-23水平分别为（2．38±0．59）％、（7．724±0．780）Pg／ml、（148．412±7．355）Pg／ml、（55．668±7．532）Pg／ml，均高于初治组和CHOP．cR组（P〈0．05）；RCHOP—CR组TGF—β水平为（283．904±59．223）Pg／ml，低于CHOP-CR组的（341．481±95．597）Pg／ml（P〈0．05）。结论Thl7细胞可能与DLBCL的发生发展呈负相关，IL-23水平降低和TGF—B水平升高可能抑制Th17细胞的分化；利妥昔单抗可提高DLBCL患者Thl7细胞比例，且与化疗效果有关。

Objective To understand the changes of Th17 cells and related cytokines in diffuse large B-cell lymphoma （DLBCL） patients treated with rituximab and its significances. Methods Patients were assigned to 4 groups,there were 20 cases in the control group,31 cases in the initial treatment group, 31 cases in CHOP group and 25 cases in RCHOP group. The percentage of Thl7 cells in the peripheral blood of each group was tested by flow cytometry, the related eytokines IL-17, IL-21, IL-23, TGF-β in the peripheral blood were measured by enzyme-linked immunosorbent assay. Results The percentage of Thl7 cells and the levels of IL-17, IL-21, IL-23 in the initial treatment group [（0.67±0.21） %, （5.929±1.342） pg/ml, （130.632±17.945） pg/ml, （51.681±9.808） pg/ml] and the CHOP-CR group [（1.07±0.37） %, （6.526±0.538） pg/ml, （132.119±7.700） pg/ml, （50.245±7.668） pg/ml] were both significantly lower than those in the control group[（2.53±0.63） %, （8.435±2.031） pg/ml, （149.265±12.316） pg/ml, （55.303±7.778） pg/ml] （P 〈 0.05）. The level of TGF-β in the initial treatment group [（370.615±98.444） pg/ml] was significantly higher than that in the control group [（311.895±73.365） pg/ml] （P 〈 0.05）. The percentage of Thl7 cells and the levels of IL-17, [L-21, IL-23 in the RCHOP-CR group [（2.38±0.59） %, （7.724±0.780） pg/ml, （148.412±7.355） pg/ml, （55.668±7.532） pg/ml] were significantly higher than those in the initial treatment group [（0.67±0.21） %, （5.929±1.342） pg/ml, （130.632±17.945） pg/ml, （51.681±9.808） pg/ml] and the CHOP-CR group [（1.07±0.37） %, （6.526±0.538） pg/ml, （132.119±7,700） pg/m], （50.245±7.668） pg/ml] （P 〈 0.05）. The level of TGF-β in the RCHOP-CR group[（283.904±59.223） pg/ml] was significantly lower than that in the CHOP-CR group [（341.481±95.597） pg/ml] （P 〈 0.05）. Conclusion Th17 cells might be negatively correlated with the DLBCL development,the reduced IL-23 and elevated TGF-β might suppress the differentiation of Th17 cells. Rituximab could elevate the percentage of Thl7 cells in DLBCL patients, and it is related with the effect of chemotherapy.