辐照红细胞输注对肝癌患者CD4^+T细胞亚群失衡的影响

Effect of irradiated blood transfusion on imbalance of CD4^+T cell subset in patients with hepatocellular carcinoma

目的研究输注辐照红细胞对肝癌患者外周血CD4+T细胞亚群Th1/Th2、Th17/Treg失衡及相关细胞因子的影响。方法选择64例肝癌患者为研究对象,其中输注辐照红细胞患者38例作为辐照组,输注普通悬浮红细胞患者26例作为未辐照组。分别于输血前及输血后14 d,采用流式细胞术检测2组患者外周血Th1、Th2、Th17及Treg细胞比率,酶联免疫吸附试验(ELISA)检测2组患者血清白细胞介素-2 (IL-2)、干扰素-γ(IFN-γ)、IL-4、IL-6、IL-17、IL-10水平。结果输血后14 d,辐照组Th1细胞比率、Th2细胞比率、Th1/Th2比值、Th17细胞比率、Treg细胞比率、Th17/Treg比值及血清IL-2、IFN-γ、IL-4、IL-6、IL-17、IL-10水平与输血前比较差异均无统计学意义(P均>0. 05);未辐照组外周血Th1细胞比率、Th1/Th2比值、Th17/Treg比值和血清IL-2、IFN-γ水平均明显低于输血前及辐照组(P均<0. 05),Th2细胞比率、Treg细胞比率及血清IL-4、IL-6、IL-17、IL-10水平均明显高于输血前及辐照组(P均<0. 05),2组Th17细胞比率比较差异无统计学意义(P> 0. 05)。结论输血引起的Th1/Th2、Th17/Treg细胞因子失衡可能与异体血中的白细胞和血浆成分有关,肿瘤患者输辐照红细胞可减轻输血引起的免疫抑制。

Objective It is to explore the effect of irradiated blood transfusion on imbalance of Th1/Th2,Th17/Treg cytokine in peripheral blood and related cytokines in the patients with hepatocellular carcinoma.Methods Sixty-four patients with hepatocellular carcinoma were enrolled in the study,in which the ones received irradiated blood transfusion as the irradiated group(38 patients),and the ones transfused allogeneic red blood cell(RBC)as non-irradiated group(26 patients).Flow cytometry(FCM)was applied to determine Th1、Th2、Th17 and Treg levels in peripheral blood,while the plasma cytokines levels of Th1(IL-2,IFN-γ),Th2(IL-4,IL-6),Th17(IL-17)and Treg(IL-10)were determined by enzyme linked immunosorbent assays(ELISA)in the two groups.Results At 14 days after transfusion,the difference in the ratio of Th1 cells,Th2 cell ratio,Th1/Th2 ratio,Th17 cell ratio,Treg cell ratio,Th17/Treg ratio and the levels of serum IL-2,IFN-γ,IL-4,IL-6,IL-17 and IL-10 were not significant compared with those before blood transfusion in the irradiated group(P>0.05);Peripheral blood Th1 cell ratio,Th1/Th2 ratio,Th17/Treg ratio and the levels of serum IL-2 and IFN-γwere significantly lower while the ratio of Th2 cells,Treg cells and the levels of serum IL-4,IL-6,IL-17 and IL-10 were significantly higher in the non-irradiated group than those before transfusion and in the irradiated group(P<0.05).there was no significant difference in the ratio of Th17 cells between the two groups(P>0.05).Conclusion The imbalance of Th1/Th2 and Th17/Treg cytokines caused by blood transfusion may be related to the white blood cells and plasma components in allogeneic blood.The irradiation of red blood cells in tumor patients can reduce the immunosuppression caused by blood transfusion.