氯胺酮对胃肠道肿瘤患者Th1和Th2细胞的影响

Effect of ketamine on Th1 and Th2 cells in patients with gastrointestinal cancer

目的:探讨不同浓度氯胺酮对胃肠道肿瘤患者1型辅助性T细胞(helper T cell,Th1)和2型辅助性T细胞(helper T cell,Th2)的影响。方法:选择胃肠道肿瘤患者240例随机的分为A、B、C、D 4组,每组60例,收集患者外周静脉血分离外周血单个核细胞,各组分别加入佛波纯-十四酸酯-乙酸酯(PMA)和离子霉素的混合液2μL,B组加入25μmol/L氯胺酮、C组加入50μmol/L氯胺酮,D组加入100μmol/L氯胺酮,孵育4 h后收集细胞,用3色荧光流式细胞技术测定各组Th1和Th2细胞亚群,计算两者的比值(Th1/Th2)。结果:与A组比较,B组Th1和Th2细胞亚群以及Th1/Th2比较差异无统计学意义(P>0.05),D组Th1和Th2细胞亚群比例降低(P<0.05),Th1/Th2升高(P<0.05);B组和C组Th1/Th2低于D组(P<0.05)。结论:胃肠道肿瘤诱导免疫应答的过程中Th1/Th2平衡偏移向Th2,体外PMA和离子霉素的刺激下,氯胺酮浓度越大,抑制Th细胞分化、增加Th1/Th2比值作用越明显。

Objective： To investigate the effects of different concentrations of ketamine on Thl and Th2 cells in patients with gastrointestinal cancer. Methods：240 cases of patients with gastrointestinal cancer were selected and randomly divided into group A, B, C and D, 60 cases in each group. PBMCs were isolated from peripheral venous blood collected from the patients and 2 μL mixture of PMA and ionomycin were added in each group. 25 μmol/L ketamine was added in group B, 50μmol/L ketamine was added in group C and 100 μmol/L ketamine was added in group D. The cells were collected after 4 hours＇incubation. Thl and Th2 cell subsets in each group were determined by 3 color fluorescence flow cytome- try, and the ratio between Tbl and Th2 was calculated. Results：Compared with those in group A, Thl cell subsets, Th2 cell subsets and Thl/Th2 ratio in group B had no significant difference（ P 〉 0.05 ） ; the proportion of Thl and Th2 cell subsets in group D decreased （ P 〈 0.05 ）, and the Thl/Th2 ratio increased （ P 〈 0.05 ）. Compared with that in group D, the Thl/Th2 ratio in group B and C decreased （ P 〈 0.05 ）. Conclu- sion ：Thl/Th2 balance shift to Th2 in the process of immune response induced by gastrointestinal cancer. With the stimulation of PMA in vitro and ionomycin, the higher the concentrations of ketamine becomes, the greater effects on the inhibition of Th ceils and the increase of Thl/Th2 ratio will be.