慢性鼻窦炎伴鼻息肉患者外周血中髓源性抑制细胞的变化及临床意义

Changes and clinical significance of myeloid-derived suppressor cells in peripheral blood of patients with chronic sinusitis with nasal polyps

目的:研究慢性鼻窦炎伴鼻息肉(chronic sinusitis with nasal polyps,CRSwNP)患者外周血中髓源性抑制细胞(myeloid-derived suppressor cells,MDSCs)及其亚群比例和功能的变化,探讨MDSCs对CRSwNP疾病进展的影响。方法:采用流式细胞术检测CRSwNP组(31例)及对照组(36例)外周血中HLA-DR-CD11b+CD33+MDSCs,HLA-DR-CD11b+CD33+CD14-CD15+粒细胞性MDSCs(PMN-MDSCs)和HLA-DR-CD11b+CD33+CD14+CD15-单核细胞性MDSCs(M-MDSCs)的比例和功能分子精氨酸酶-1(arginase-1,ARG-1)的表达情况,同时采用ELISA检测血浆中IL-6的浓度。结果:CRSwNP患者外周血总MDSCs比例明显高于对照组,差异有统计学意义(P<0.01);与对照组比较,CRSwNP组PMN-MDSCs比例明显升高(P<0.05),而M-MDSCs比例下降(P<0.05)。CRSwNP组总MDSCs中ARG-1的平均荧光强度升高(P<0.05),血浆IL-6浓度增加(P<0.05)。结论:CRSwNP患者中总MDSCs的表达升高且以PMN-MDSCs为主,其功能分子ARG-1表达增强,提示MDSCs可能参与了慢性鼻窦炎的发病过程。

Objective:To investigate the changes in the ratio and function of myeloid-derived suppressor cells(MDSCs)and its subgroups in patients with chronic sinusitis with nasal polyp(CRSwNP),and explore the influence of MDSCs on the occurrence and development of CRSwNP.Methods:Flow cytometry(FCM)was used to detect the ratio of HLA-DR-CD11b+CD33+MDSCs,HLA-DR-CD11b+CD33+CD14-CD15+PMN-MDSCs and HLA-DR-CD11b+CD33+CD14+CD15-M-MDSC,and the expression of the functional molecule arginase-1(ARG-1)in peripheral blood in the CRSwNP group(31 cases)and control group(36 cases).At the same time,the concentration of IL-6 in plasma was detected by enzyme-linked immunosorbent assay.Results:The proportion of total MDSCs in the peripheral blood of CRSwNP patients was significantly higher than that of the control group(P<0.01).Among them,the proportion of PMN-MDSCs in the CRSwNP group was significantly increased(P<0.05);while the proportion of M-MDSCs decreased(P<0.05).The average fluorescence intensity of ARG-1 in the total MDSCs in the CRSwNP group increased(P<0.05),and the plasma IL-6 concentration also increased(P<0.05).Conclusion:The expression of total MDSCs in CRSwNP patients is increased and PMN-MDSCs are the dominant ones,and the expression of ARG-1 is also increased.It suggests that MDSCs may be involved in the occurrence and development of chronic sinusitis.