骨髓增生异常综合征患者CD4+CD25+FoxP3+Treg细胞特点及环孢素对其的影响

Characteristics of CD4+ CD25+ FoxP3+ Treg cells in patients with myelodysplastic syndrome and the effect of cyclosporine

目的探讨骨髓增生异常综合征(myelodysplastie syndrome,MDS)-难治性贫血(refractory anemia,RA)及难治性血细胞减少伴有多系发育异常(refractory cytopenia with multiple dysplasia,RCMD)患者CD4+CD25+FOXP3+Treg细胞与白细胞介素(interleukin,IL)-10表达水平,评估环孢素对MDS患者CD4+CD25+FOXP3+Treg细胞的影响。方法选择2016年1月至2018年1月于新疆维吾尔自治区人民医院25例MDS-RA及RCMD患者(MDS组)和13名健康对照(健康对照组),采用流式细胞术及酶联免疫吸附试验检测外周血标本CD4+CD25+FOXP3+Treg与IL-10表达水平,检测MDS-RA及RCMD患者在应用以环孢素为基础的免疫抑制方案治疗前、治疗6个月后及MDS组治疗有效及无效的CD4+CD25+FOXP3+Treg与IL-10的表达情况。结果全部25例患者中,13例(52%)有效,12例(48%)无效。MDS组CD4+CD25+FOXP3+Treg占CD4+T细胞比例显著高于健康对照组[(0.37±0.10)%与(0.12±0.06)%,t=2.02,P<0.001]。MDS组IL-10水平显著高于健康对照组[(7.16±1.27)μg/L与(2.75±1.06)μg/L,t=2.03,P<0.001]。MDS治疗有效组CD4+CD25+FOXP3+Treg细胞比例低于无效组[(0.15±0.06)%与(0.26±0.08)%,t=1.71,P<0.001],有效组IL-10水平低于无效组[(3.22±1.01)μg/L与(4.25±1.22)μg/L,t=2.06,P=0.030]。25例MDS患者外周血CD4+CD25+FOXP3+Treg比例与IL-10表达水平呈正相关关系(r=0.35,P=0.02)。结论MDS患者存在CD4+CD25+FOXP3+Treg细胞与IL-10的表达升高,环孢素治疗后降低。

Objective To investigate the expression levels of CD4+CD25+FOXP3+Treg cells and interleukin(IL)-10 in serum of patients with myelodysplastic syndrome(MDS)-refractory anemia(RA)and refractory hematopenia with multilineage dysplasia(RCMD),and to evaluate the effect of cyclosporine on CD4+CD25+FOXP3+Treg cells in MDS patients.Methods From January 2016 to January 2018,25 MDS-RA and RCMD patients and 13 healthy controls were selected from people′s Hospital of Xinjiang Uygur Autonomous Region for retrospective analysis.The expression of CD4+CD25+Foxp3+Treg and IL-10 in peripheral blood samples were detected by flow cytometry and enzyme-linked immunosorbent assay.The expression of CD4+CD25+Foxp3+Treg and IL-10 in MDS-RA and RCMD patients before and 6 months after the treatment with CSA based immunosuppressive regimen was detected.Results Of the 25 patients,13(52%)were effective and 12(48%)were ineffective.The proportion of CD4+CD25+Foxp3+Treg in CD4+T cells of MDS group was significantly higher than that of healthy control group[(0.37±0.10)%and(0.12±0.06)%respectively,t=2.02,P<0.001].The level of IL 10 in MDS group was significantly higher than that in healthy control group((7.16±1.27)μg/L and(2.75±1.06)μg/L,t=2.03,P<0.001).The ratio of CD4+CD25+Foxp3+Treg cells in MDS group was lower than that in MDS Group((0.15±0.06)%and(0.26±0.08%),t=1.71,P<0.001),and the level of IL 10 in MDS group was lower than that in MDS Group((3.22±1.01)μg/L and(4.25±1.22)μg/L,t=2.06,P=0.030).The proportion of CD4+CD25+Foxp3+Treg in peripheral blood of 25 MDS patients was positively correlated with the level of IL-10 expression(r=0.35,P=0.02).Conclusion The expression of CD4+CD25+FOXP3+Treg cells and IL-10 increased in MDS patients increased,but decreased after cyclosporine treatment.