不同分期慢性淋巴细胞白血病患者外周血T-bet、GATA-3、RORγt和Foxp3 mRNA的表达变化

mRNA Expressions of T-bet,GATA-3,ROR γt and Foxp3 in Peripheral Blood of Patients with Chronic Lymphocytic Leukemia in Different Stages

目的:研究特异性转录因子T-bet、GATA-3、RORγt和Foxp3 mRNA在不同分期慢性淋巴细胞白血病(CLL)患者外周血中的表达情况并探讨其在CLL发病机制中可能的作用及临床意义。方法:选择46例初诊未治疗CLL患者为病例组(其中Binet A期15例,Binet B期16例,Binet C期15例),20名健康人作为对照组,通过荧光实时定量PCR方法分别检测各组外周血单个核细胞(PBMNC)中T-bet、GATA-3、RORγt和Foxp3 mRNA的表达。结果:1 CLL患者外周血中T-bet mRNA表达低于正常对照组(P<0.05),GATA-3、RORγt、Foxp3 mRNA的表达均高于正常对照组(P值均<0.05),T-bet/GATA-3与RORγt/Foxp3比值均低于正常对照组(P值均<0.05);2分期越晚,GATA-3 mRNA和Foxp3 mRNA的表达量越高,其中B期和C期的GATA-3 mRNA表达高于A期(P<0.05),C期的Foxp3 mRNA表达高于A期和B期(P<0.05);分期越晚,T-bet/G ATA-3和RORγt/Foxp3比值越低。其中A期的T-bet/GATA-3比值高于C期(P<0.05),A期与B期的RORγt/Foxp3比值均高于C期(P<0.05)。结论:本研究从转录因子层面发现在CLL患者中,随着病程的进展,Th1/Th2和Th17/Treg平衡分别向Th2和Treg偏移,Treg细胞可能在CLL的发生发展中起着重要的免疫抑制作用。

Objective： This study was to investigate the mRNA expression of T-bet, GATA-3, ROR γt and Foxp3 mRNA in peripheral blood of patients with chronic lymphocytic leukemia （ CLL ） in different stages and explore their potential role in the pathogenesis and clinical diagnosis. Methods： A total of 46 newly diagnosed and untreated patients with CLL was chosen as patient group, including 16 patients in the stage of Binet A, 15 in the stage of Binet B, and 15 in the stage of Binet C; 20 healthy persons were selected as controls. The quantitative fluorescence PCR was adopted to detect the mRNA expression of T-bet, GATA-3, RORTt and Foxp3 in peripheral blood mononuclear cell （PBMNC）. Results ： （ 1 ） The expression of T-bet mRNA in patient group was lower than that in normal controls（ P 〈 0.05 ）, while the mRNA expression of GATA-3 mRNA, ROR 7t, Foxp3 in CLL patients group were higher than that in normal controls （ P 〈 0. 05 ）, and the ratio of T-bet/GATA-3 and RORγt/Foxp3 in CLL in patient group were lower than that in normal controls（P〈0.05） ; （2） The later the stage, the higher the mRNA expression of GATA-3 and Foxp3. The mRNA expression of GATA-3 in stage Binet B and stage Binet C of CLL patients were higher than that in stage Binet A （ P 〈 0.05 ）, and the mRNA expression of Foxp3 in stage Binet C was higher than that in stage of Binet A and Binet B （ P 〈 0. 05 ） ; the later the stage, the lower the ratio of T-bet/GATA-3 and RORγt/Foxp3. The ratio of T-bet/GATA-3 in stage of Binet A CLL patients was higher than that in stage Binet C （ P 〈 0.05 ） and the ratio of RORγt/Foxp3 in stage of Binet A and stage of Binet B were higher than that in stage Binet C （ P 〈 0.05 ）. Conclusion： This study found in the level of transcription factors in CLL patients that with the process of disease, the balance shifts from Thl/Th2 and Thl7/Treg to Thl7 and Treg, and Treg cell may play a critical immunosuppressive role in the development of CLL.