MDS、AML患者T淋巴细胞及相关细胞因子表达水平的研究

Expression of T lymphocytes and related cytokines of patients with myelodysplastic syndrome and acute myeloid leukemia

目的通过检测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淋巴细胞及其分泌的相关细胞因子表达水平的变化,研究此两种疾病免疫状态的区别并指导治疗。方法采用流式细胞微球芯片捕获术(CBA)及流式细胞术检测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]、15例AML患者(AML组)和10名健康体检者(正常对照组)外周血中调节性T细胞(Treg)、白细胞介素-2(IL-2)、γ-干扰素(IFN-γ)、肿瘤坏死因子(TNF)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)的表达水平,间接评价各组T淋巴细胞免疫状态,并作比较。结果与正常对照组相比,RA组TNF、IL-17、IL-2、IFN-γ表达水平均较高(P<0.05),RAEB组和AML组Treg、IL-10、IL-6、IL-4表达水平均较高(P<0.05)。与MDS-RA组比较,MDS-RAEB组和AML组TNF、IL-17、IL-2、IFN-γ表达水平均较低(P<0.05),而Treg、IL-10、IL-6、IL-4表达水平均较高(P<0.05)。结论不同时期的MDS和AML患者其免疫状态并不相同。

Objective By detecting the changes of peripheral blood T lymphocytes and their related cytokines expression in patients with myelodysplastic syndrome（MDS） and acute myeloid leukemia（AML）,and to study the difference between the immune status of these two diseases and guide clinical treatment.Methods Cytometric bead array（CBA） and flow cytometry were used to measure the expression levels of Treg,IL-2,IFN-γ,TNF,IL-4,IL-6,IL-10,IL-17 in peripheral blood from 20 patients with MDS（MDS group：10 with RA and 10 with RAEB）,15 patients with AML（AML group） and 10 healthy individuals（normal control group）,and indirect evaluation each T lymphocyte immune status.Results Compared with the normal control group,the levels of TNF,IL-17,IL-2 and IFN-γ in the RA group were significantly up-regulated（all P0.05）.Treg,IL-10,IL-6 and IL-4 levels in patients with RAEB and AML were considerably up-regulated（both P0.05）.The expression levels of TNF,IL-17,IL-2 and IFN-γ in the MDS-RAEB and AML groups was significantly lower whereas the level of Treg,IL-10,IL-6,IL-4 was significantly higher than those in the MDS-RA group（all P0.05）.Conclusion Different stages of MDS and AML patients is under different immune status.