不同集落刺激因子对完全缓解急性髓系白血病患者树突状细胞亚群的影响

Different colony stimulating factor on the effect of acute myeloid leukemia in patients with complete remission of dendritic cell subsets

目的研究粒系集落刺激因子（G—CSF）和粒单系集落刺激因子（GM-CSF）对完全缓解急性髓系白血病（AML）患者树突状细胞（DC）的功能及其亚群变化。方法将36例化疗达完全缓解的AML患者根据随机数字表法分为三组，G组给予G-CSF200μg/d皮下注射，GM组给予GM—CSF200μg/d皮下注射，对照组（c组）皮下注射0．9％氯化钠注射液。比较其疗效。结果G组DC表面CD80、CD83和CD86表达均低于GM组和C组（t=4．34、5．43、4．54、4．54、5．25、3．54，均P〈0．05），GM组DC表达CDllc高于G组和C组（t=4．54、4．27，均P〈0．05）。G组和GM组DC促淋巴细胞增殖能力均高于c组（t=4．54、5．64，均P〈0．05）；GM组DC促进CD4＋T淋巴细胞增殖的能力高于G组（t=3．54，P〈0．05）。ELISA法检测发现，GM组DC分泌IL-12高于G组和C组；G组DC分泌IL-10高于GM组和c组（t=3．54、4．23、4．32、3．87，均P〈0．05）。结论G-CSF和GM—CSF可使完全缓解AML患者DC亚群发生偏移，G-CSF促使其偏向DC2而具有一定免疫抑制作用，而GM-CSF使DC亚群偏向DC1而促进细胞免疫。

Objective To study the granulocyte colony stimulating factor（G-CSF） and granulocyte macro- phage colony stimulating factor（GM-CSF） in complete remission of acute myeloid leukemia（AML） patients with den- dritic cells （DC） changes in the function and its subsets. Methods 36 cases of complete remission according to AML patients were randomly divided into 3 groups, G group was given G-CSF 200g/d, subcutaneous injection, GM group were given GM-CSF 200g/d, subcutaneous injection, the control group were injected with normal saline. The curative effects were compared. Results The expression of G in group DC, CD83 and CD86 on surface of CD80 were lower than that in GM group and C group （ t = 4.34,5.43,4.54,4.54,5.25,3.54, all P 〈 0. 05 ）, GM group, DC expression of CD11 c was higher than that of G group and C group （t = 4.54,4.27, all P 〈 0.05 ）. G group and GM group DC in promoting lymphocyte proliferation were higher than those in C group （ t = 4.54,5.64, all P 〈 0.05 ） ; group GM DC to promote the ability of CD4 ~ T lymphocyte proliferation was higher than that of G group （ t -- 3.54, P 〈 0.05 ）. ELISA assay,GM group DC secretion of IL-12 than that of group G and C group;group G DC secretion of IL-10 was higher than that of GM group and C group （ t = 3.54.4.23,4.32,3.87, all P 〈 0.05 ）. Conclusion G-CSF and GM-CSF can make the complete remission in patients with AML subgroup DC shift, the bias of G-CSF DC2 and certain immuno- suppressive effect,while GM-CSF DC subsets of DC1 and promotes cell immune deviation.