【摘要】：目的:探討骨髓增生異常綜合征(MDS)患者血清新型免疫抑制因子——IL-35表達水平及其誘導產生的新型調節(jié)性T細胞iTR35的臨床意義。方法:選取2014年1月至2016年1月福建省泉州市第一醫(yī)院血液科收治的23例初診MDS患者為研究對象,根據MDS國際預后積分系統(IPSS)將其分為高危(n=4),中危-2(n=10),中危-1(n=5)和低危型(n=4)4個亞組。選取同期在我院體檢的20例正常人為正常對照組。分別采用酶聯免疫吸附試驗(ELISA)和流式細胞術(FCM)檢測各亞組患者血清IL-35表達水平及iTR35細胞比例。結果:MDS組患者外周血CD4~+CD25~+Foxp3~+Treg細胞比例顯著高于對照組(P0.01),iTR35細胞比例高于正常對照(P0.01),而兩組的CD4~+CD25~-Foxp3~+Treg細胞比例無顯著的統計學差異(P0.05)。MDS組的血清IL-35水平顯著高于對照組(P0.05),Treg細胞內IL-12p35和IL-27EBl3表達水平也較對照組顯著上調(P0.05),且MDS組的血清IL-35水平與IL-12p35和IL-27EBl3表達水平及iTR35細胞比例呈正相關(r分別為0.92、0.99和0.52,P0.05)。MDS的4個亞組中,iTR35細胞比例及血清IL-35表達水平總體具有顯著性差異(P0.05),高危組與中危-2組患者的血清IL-35水平無明顯差別(P0.05),但兩組均分別明顯高于中危-1組和低危組(P0.05),中危-2組也明顯高于中危-1組及低危組(P0.05),而中危-1組與低危組無差別(P0.05)。高危組與中危-2組的iTR35細胞比例無顯著差別,但高危組和中危-2組的iTR35細胞比例均顯著高于中危1組和低危組(P0.05),而中危1組與低危組無明顯差別(P0.05)。結論:IL-35水平和iTR35細胞的數量和(或)功能失衡在MDS發(fā)生、發(fā)展過程中起著重要作用,有望為MDS免疫靶向治療研究提供新的理論依據。
[Abstract]:Aim: to investigate the expression level of serum novel immunosuppressive factor-IL-35 in patients with myelodysplastic syndrome (MDS) and its clinical significance in inducing new regulatory T cell iTR35. Methods: from January 2014 to January 2016, 23 newly diagnosed MDS patients in Department of Hematology, first Hospital of Quanzhou City, Fujian Province were selected as study subjects. According to the International prognosis integral system (IPSS) of MDS, they were divided into 4 subgroups: high risk (nong4), moderate risk 2 (nong10), moderate risk 1 (nong5) and low risk type (n4). 20 normal subjects in our hospital were selected as the normal control group. Elisa and FCM were used to detect the expression of IL-35 in serum and the proportion of iTR35 cells in each subgroup. Results the percentage of CD4 ~ CD25 ~ Foxp3 ~ Treg cells in the patients with MDS was significantly higher than that in the control group (P0.01). However, there was no significant difference in the proportion of CD4 ~ CD25- Foxp3 ~ Treg cells between the two groups (P0.05). The level of serum IL-35 in the MDS group was significantly higher than that in the control group (P0.01). The expression of IL-12p35 and IL-27EBl3 in Treg cells in the MDS group was significantly higher than that in the control group (P0.05), and the serum IL-35 level was positively correlated with the expression of IL-12p35 and IL-27EBl3 and the proportion of iTR35 cells in the MDS group (r = 0.92, 0.99 and 0.52P0.05, respectively). The percentage of iTR35 cells and the percentage of serum iTR35 cells in MDS subgroups were positively correlated with the expression levels of IL-12p35 and IL-27EBl3 in MDS group (r = 0.92, 0.99 and 0.52P0.05, respectively). The level of IL-35 expression was significantly higher in the high risk group than in the middle risk group (P0.05), but the level of IL-35 in the high risk group was significantly higher than that in the moderate risk group and the low risk group (P0.05), and the level of IL-35 in the middle risk group was significantly higher than that in the middle risk group and the middle risk group (P0.05). Low risk group (P0.05), but moderate risk-1 group and low risk group had no difference (P0.05). There was no significant difference in the proportion of iTR35 cells between high risk group and moderate risk 2 group, but the proportion of iTR35 cells in high risk group and middle risk 2 group was significantly higher than that in middle risk 1 group and low risk group (P0.05), but there was no significant difference between middle risk group and low risk group (P0.05). Conclusion the imbalance of cell number and / or function in MDS may play an important role in the pathogenesis and development of MDS, which is expected to provide a new theoretical basis for the study of MDS immunoreactive therapy.
【作者單位】： 福建醫(yī)科大學附屬泉州第一醫(yī)院血液科;
【分類號】：R551.3
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本文編號：2128402