急性淋巴细胞白血病患儿外周血IL-2、IL-17、NK细胞水平变化及对免疫功能的影响

Changes of peripheral blood IL-2,IL-17,and NK cell levels and their effects on immune function in children with acute lymphoblastic leukemia

目的 探讨急性淋巴细胞白血病(ALL)患儿外周血白细胞介素-2(IL-2)、白细胞介素-17(IL-17)、自然杀伤细胞(NK)水平变化及对免疫功能的影响。方法 选取于2014年6月至2017年6月本院肿瘤科就诊的ALL患儿115例作为研究对象,首次被确诊未经治疗的58例患儿作为未治疗组,经过系统治疗完全缓解的57例患儿作为治疗缓解组,另外选取健康体检的儿童50例作为对照组,采用流式细胞术检测各组患儿CD3+T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞、NK细胞水平,采用酶联免疫吸附试验(ELISA)方法测定血清IL-2、IL-17水平。结果 未治疗组CD3+、CD4+、NK细胞水平显著低于对照组(P<0.05),CD8+水平显著高于对照组(P<0.05),治疗缓解组CD3+、CD4+、CD8+、NK细胞水平达到正常水平,与对照组比较差异无统计学意义(P>0.05)。未治疗组和治疗缓解组外周血IL-2水平显著低于对照组(P<0.05),未治疗组外周血IL-2水平低于治疗缓解组(P<0.05);未治疗组和治疗缓解组外周血IL-17水平显著高于对照组(P<0.05),未治疗组外周血IL-17水平高于治疗缓解组(P<0.05)。IL-2与CD3+、CD4+、NK细胞与呈正相关(r=0.762、0.945、0.771,P<0.05);IL-17与CD4+、NK细胞呈负相关(r=﹣0.562、﹣0.619,P<0.05),而与CD8+呈正相关性(r=0.669,P<0.05)。结论 ALL患儿免疫功能低下,外周血T淋巴细胞亚群和NK细胞存在不同程度的异常,外周血细胞因子IL-2降低、IL-17升高参与了ALL的发生发展。

Objective To explore the changes of peripheral blood interleukin(IL)-2,IL-17,and natural killer(NK)cell levels and their effects on immune function in children with acute lymphoblastic leukemia(ALL).Methods 115 cases of ALL children treated in our oncology department from June 2014 to June 2017 were selected as subjects,58 children who were confirmedly diagnosed but no yet treated as untreated group,57 children who were completely relieved after systematic treatment as treatment relief group,and 50 healthy children were selected as control group.Flow cytometry(FCM)was used to measure the expression of T lymphocyte subsets and NK cells,and enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of IL-2,IL-17.Results The levels of CD3+,CD4+,and NK cells in untreated group were significantly lower than those in control group(P<0.05),CD8+level was significantly higher than that in control group(P<0.05);the levels of CD3+,CD4+,CD8+,and NK cells in the treatment relief group reached normal levels,and there were no statistically significant differences compared with control group(P>0.05).The level of peripheral blood IL-2 in untreated group and treatment relief group were significantly lower than that in control group(P<0.05),the level of peripheral blood IL-2 in untreated group was lower than that in treatment relief group(P<0.05);the level of peripheral blood IL-17 in untreated group and treatment relief group were significantly higher than that in control group(P<0.05),the level of peripheral blood IL-17 in untreated group was higher than that in treatment relief group(P<0.05).The level of peripheral blood IL-2 was positively correlated with the expression of CD3+,CD4+,and NK cells(r=0.762,0.945,0.771,P<0.05);the level of peripheral blood IL-17 was negatively correlated with the expression of CD4+and NK cells(r=-0.562,-0.619,P<0.05),and positively correlated with the expression of CD8+cells(r=0.669,P<0.05).Conclusion There are immune disorders of varying degrees in ALL children.There were different degrees of abnormalities in peripheral blood T lymphocyte subsets and NK cells,the decreased level of peripheral blood IL-2 and increased level of peripheral blood IL-17 participate in the development of ALL.