骨髓增生异常综合征T细胞早期激活及可溶性肿瘤坏死因子受体的研究

A study on early activation of T lymphocytes and soluble tumor necrosis factor receptor in patients with myelodysplastic syndrome

目的 研究骨髓增生异常综合征 (MDS)外周血CD+ 4 、CD+ 8T细胞早期激活标志CD69的表达及血清、骨髓可溶性肿瘤坏死因子受体 1、2 (sTNF R1、2 )的水平及其意义。方法 在植物血凝素 (PHA) 2 0mg/L条件下进行全血细胞培养 ,于 0h和 4h分别用流式细胞仪对CD+ 4 、CD+ 8T细胞CD69的表达进行分析。用ELISA法检测血清和骨髓sTNF R1、2的水平。结果 PHA刺激前难治性贫血 (RA)与难治性贫血伴环形铁粒幼细胞增多 (RAS)CD+ 4 、CD+ 8细胞CD69的表达率分别为 8 32 %、9 88% ,难治性贫血伴原始细胞增多 (RAEB)与转变中的RAEB(RAEB T)CD+ 8细胞CD69的表达率为7 92 %。PHA刺激后MDS患者CD+ 4 、CD+ 8细胞表达CD69明显增强 ,RA +RAS为 5 3 4 6 %、5 1 6 3% ;RAEB +RAEB T为 4 2 93%、4 1 96 % ,CD+ 4 与CD+ 8细胞CD69的表达率相似。MDS两种sTNF R1水平均明显升高 ,RA +RAS组sTNF R1血清为 (1 5 8± 0 6 8) μg/L ,骨髓为 (2 10± 0 2 6 ) μg/L ;sTNF R2血清为 (1 4 1± 0 5 0 ) μg/L ,骨髓为 (1 95± 0 6 4 ) μg/L ;RAEB +RAEB T组sTNF R1血清为 (2 6 2± 2 5 5 ) μg/L ,骨髓为 (3 12± 0 6 7) μg/L ;sTNF R2血清为 (1 96± 0 5 6 ) μg/L ,骨髓为(3 0 9± 0 6 2 ) μg/L。血清sTNF

Objective To investigate the expression of T cell early activation marker(CD 69 )on CD + 4 and CD + 8 lymphocytes in peripheral blood and the levels of soluble tumor necrosis factor receptor 1 (sTNF-R1) and sTNF-R2 in serum and bone marrow in patients with myelodysplastic syndrome(MDS). Methods Whole blood cell culture procedure was applied to activate T lymphocytes with phytohemagglutinin(PHA) (20 mg/L) in v itro. The expression rates of CD 69 on CD + 4 and CD + 8 lymphocytes at 0 h and 4 h after culture were analyzed with two-color flow cytometry. The levels of sTNF-R1 and sTNF-R2 in serum and bone marrow were measured with ELISA. Results There was an increase in the expression rates of CD 69 on CD + 4 and CD + 8 cells in RA and RAS patients (8.32% and 9.88% respectively )and in the expression rate of CD 69 on CD + 8 cells in RAEB and RAEB-T patients(7.92% )before PHA stimulation.CD 69 expression on CD + 4 and CD + 8 cells were significantly elevated in MDS patients after PHA stimulation (53.46% and 51.63% in RA+RAS; 42.93% and 41.96% in RAEB and RAEB-T) and the expression rate on CD + 4 cells was similar to that on CD + 8 cells .The levels of the two sTNF-R in MDS patients were elevated. sTNF-R1 in RA and RAS(1.58±0.68)μg/L(PB),(2.10±0.26)μg/L(BM);sTNF-R2 in RA and RAS (1.41±0.50)μg/L(PB),(1.95±0.64)μg/L(BM);sTNF-R1 in RAEB and RAEB-T (2.62±2.55) μg/L(PB),(3.12±0.67)μg/L (BM);sTNF-R2 in RAEB and RAEB-T (1.96±0.56) μg/L(PB),(3.09±0.62) μg/L(BM).The levels of sTNF-R2 in serum positively correlated to the expression rate of CD 69 on CD + 8 cells before PHA stimulation.Conclusion It is indicate that the increased early activation and activated potentials of T lymphocytes,along with abnormally elevated immunologically active molecules play an important role in immune pathogenesis of patients with MDS.