全反式维甲酸在多发性骨髓瘤治疗中的作用

The effect of all-trans retinoic acid on multiple myeloma

目的 探讨全反式维甲酸治疗多发性骨髓瘤的作用机理及其临床效果。方法 采用MTT法、双抗体夹心ELISA法检测了 17例多发性骨髓瘤患者应用全反式维甲酸治疗前后骨髓上清中IL 6活性及可溶性IL 6受体(sIL 6R)水平。结果 与对照组相比 ,多发性骨髓瘤患者骨髓上清中IL 6活性及sIL 6R水平明显高于对照组 (P<0 .0 1) ,应用全反式维甲酸 5 0d后多发性骨髓瘤患者骨髓上清中IL 6活性及sIL 6R水平明显降低 (P <0 .0 1) ,Ⅲ期多发性骨髓瘤患者的IL 6活性显著高于Ⅰ、Ⅱ期 (P <0 .0 5 ) ,但sIL 6R水平二者无显著性差异 (P >0 .0 5 )。用全反式维甲酸治疗的 17例患者 ,5例完全缓解 (CR)、8例部分缓解 (PR)、4例未缓解 (NR)。结论 全反式维甲酸可能是通过降低IL 6活性及sIL 6R水平而抑制肿瘤细胞生长 ,提高缓解率 ,可作为IL 6活性及sIL

Objective To observe the clinical effect of all trans retinoic acid (ATRA) on multiple myeloma and to investigate the mechanism of its role. Methods MTT and double antibody cramped ELISA assay were used to detect the activity of interleukin 6 (IL 6) and level of soluble interleukin 6 receptor (sIL 6R) of the supernant of the bone marrow of 17 multiple myeloma patients before and after being treated with ATRA. Results The activity of interleukin 6 and level of soluble interleukin 6 receptor of multiple myeloma patients were significantly higher than those of control group ( P < 0.01 ). They decreased significantly after ATRA was used for 50 days ( P < 0.01 ). The interleukin 6 activity of stage Ⅲ patients was much higher than that of stage Ⅰ or Ⅱ patients ( P < 0.05 ). There was no difference in the level of soluble interleukin 6 receptor between the two groups ( P > 0.05 ). In the 17 patients who took ATRA, 5 got completed recovery, 8 got partial recovery, and 4 came to no recovery. Conclusion All trans retinoic acid can decrease the activity of interleukin 6 and level of soluble interleukin 6 receptor so as to inhibit the proliferation of tumor cells. It can be used as an effective treatment for multiple myeloma patients whose IL 6 activity and sIL 6R level are higher than normal.