AA、MDS和AML患者外周血T淋巴细胞相关细胞因子表达水平的对比研究

Expression of T lymphocyte-related cytokines in the peripheral blood of patients with AA,MDS and AML

目的分析再生障碍性贫血(AA)、骨髓增生异常综合征(MDS)和急性髓系白血病(AML)患者外周血T淋巴细胞相关细胞因子表达水平的变化,探讨3种疾病的细胞免疫状态是否存在差异。方法采用流式细胞微球芯片捕获术(CBA)检测20例AA患者(AA组)、20例MDS患者[MDS组,难治性贫血(RA)与难治性贫血伴原始细胞增多(RAEB)各10例]、20例AML患者(AML组)和10名健康体检者(正常对照组)外周血中IL-4、IL-17、IFN-γ,TNF-α的表达水平,间接评价各组T淋巴细胞免疫状态,并作组间比较。结果与正常对照组相比,AA组IFN-γ、TNF-α、IL-17表达水平均较高,MDS-RA组IFN-γ和IL-17表达水平均较高(P均<0.05),MDSRAEB组和AML组IL-4表达水平均较高(P均<0.05)。与AA组比较,MDS组TNF-α表达水平较低(P<0.05)。与AML组比较,MDS组TNF-α、IFN-γ和IL-17表达水平均较高(P均<0.05)。与AA组比较,MDS-RAEB组和AML组IFN-γ、IL-17和TNF-α表达水平均较低(P均<0.05),但IL-4表达水平均较高(P均<0.05);与MDS-RA组比较,MDS-RAEB组和AML组IFN-γ、TNF-α和IL-17表达水平均较低(P均<0.05),而IL-4表达水平均较高(P均<0.05)。结论 AA、不同阶段MDS和AML患者所处的T淋巴细胞免疫状态并不相同。

Objective To measure the expression levels of T lymphocyte-related cytokines in the peripheral blood of patients with aplastic anemia( AA),myelodysplastic syndrome( MDS),acute myeloid leukemia( AML) for comparing the immune status of T lymphocytes in these diseases. Methods Cytometric bead array( CBA) were used to measure the expression levels of IL-4,IL-17,IFN-γ and TNF-α in the peripheral blood from 20 patients diagnosed with AA( AA group),20 with MDS( MDS group: 10 with RA and 10 with RAEB),20 with AML( AML group) and 10 healthy individuals( normal control group). The immune status of T lymphocytes was evaluated and compared among different groups. Results Compared with the normal control group,the levels of IFN-γ,TNF-α and IL-17 in the AA group were significantly up-regulated( all P <0. 05). IFN-γ and IL-17 levels in patients with MDS-RA were considerably up-regulated( both P < 0. 05).The levels of IL-4 in patients with MDS-RAEB and AML were significantly increased in comparison to normal controls( both P < 0. 05). Compared with the AA group,the level of TNF-α in the MDS group was considerably down-regulated( P < 0. 05). The expression of TNF-α,IFN-γ and IL-17 in the MDS group was significantly up-regulated compared with those in the AML group( all P < 0. 05). The expression of TNF-α,IFN-γ and IL-17 in the MDS-RAEB and AML groups was dramatically lower whereas the level of IL-4 was significantly higher than those in the AA group( all P < 0. 05). The expression levels of TNF-α,IFN-γ and IL-17 in the MDS-RAEB and AML groups was significantly lower whereas the level of IL-4 was significantly higher thanthose in the MDS-RAEB group( all P < 0. 05). Conclusion The immune status of T lymphocytes were differed among AA,various stages of MDS and AML.