摘要
目的探讨多发性骨髓瘤（MM）患者外周血中辅助性T细胞17（Thl7）和CD4＋CD25＋Foxp3＋渊节性T细胞（Treg细胞）比率的平衡关系及其在MM发病机制中的作用。方法70例MM患者分为初发组30例，平台期组23例，复发／难治组17例，以20名健康体检者为正常对照组。流式细胞术检测MM患者和正常对照者外周血中T细胞亚群及Thl7和Treg细胞占CD4＋T细胞的比率。结果初发组及复发，难治组患者外周I血Thl7细胞的比率分别为（1．62±0．65）％和（1．45±0．51）％，与正常对照组[（0．72±0，33）％]及平台期组[（0．74±0．29）％]比较，均明显增高（P值均〈0．05）；Treg细胞比率分别为（0．55±0．23）％和（0．82±0．54）％，与正常对照组[（2．33±0．90）％]及平台期组[（1．69±0．70）％]比较，明显减低（P值均〈O．05），Thl7／Treg细胞比值明显增高（P值均〈0．05）；平台期患者CD3＋CD4＋T细胞以及Thl7细胞比率与正常对照组比较差异无统计学意义（P〉0．05），Treg细胞比率明显低于正常对照组，Thl7／Treg细胞比值明冠高于正常对照组。结论MM患者外周【衄T细胞亚群紊乱以CD4＋T细胞减少为主，MM患者体内存在Thl7细胞比率升高和Treg细胞比率降低所致的Thl7／Treg细胞比例失衡，随疾病稳定而趋于正常，该免疫失衡可能在MM的发生、发展中起重要作用。
Objective To investigate the ratio of Thl7 cells and CD4＋CD25＋Foxp3＋ regulatory T （Treg） cells in peripheral blood from patients with multiple myeloma （MM） and explore its pathological effects. Methods 70 MM patients were divided into three groups：newly diagnosed group （n=30）, plateau stage group （n=23） and relapsed/refractory group （n=1 7）. The controls consisted of 20 healthy donors. The frequencies of Thl7 and Treg cells were detected by flow cytometry. Results Compared with controls [ （0.72±0.33）% ] and plateau stage group [ （0.74±0.29）% ], frequencies of Thl 7 cells were higher in newly diagnosed group [ （ 1.62±0.65）% ] and relapsed/refractory group [ （ 1.45±0.51 ）% ], respectively （P〈0.05）. Compared with controls [ （2.33±0.90）%] and plateau stage group [ （ 1.69±0.70）%], frequencies of Treg cells were significantly lower in newly diagnosed group [ （0.55±0.23）% ] and relapsed/refractory group [ （0.82 ± 0.54） % ], respectively （P〈0.05）. The ratios of Thl 7/Treg in newly diagnosed group and relapsed/refractory group were higher than those in controls （P〈0.05）. There were no differences of the frequencies of CD3＋CD4＋T cells and Thl 7 cells between plateau stage group and controls. The frequencies of Treg cells were significantly lower in plateau stage group than that in controls （P〈0.05）, and the ratio of ThlT/Treg was significantly higher in plateau stage group than that in controls （P〈0.05）. Conclusion The remarkable abnormality of T cells subsets was reduction of CD4＋ T cells in MM. Higher frequency of Thl7 and lower ratio of Treg could lead to imbalance of Thl7/Treg, which may play a critical role in the pathogenesis of MM.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2013年第11期936-940,共5页
Chinese Journal of Hematology
