CD4+CD25+CD127low/-调节性T细胞异常表达与多发性骨髓瘤的关联性分析

目的 检测多发性骨髓瘤(MM)患者和良性单克隆丙种球蛋白血症(MGUS)患者外周血及骨髓组织中CD4+CD25+CD127low/-调节性T(Treg)细胞表达水平,初探MM中调节性T细胞免疫功能状态以及与疾病发生、发展的关联性.方法 采用流式细胞术分别检测33例MM患者、44例MGUS患者和30例健康者外周血以及6例MM患者骨髓CD4+CD25+CD127low/-调节性T细胞水平.分别采用溴甲酚绿法、免疫散射比浊法检测MM患者血清清蛋白(Alb)、β2-微球蛋白(β2-MG)水平.结果 MM组外周血中CD4+CD25+CD127low/-细胞表达高于MGUS组及健康对照组,差异有统计学意义(P<0.05);MM中稳定期患者组外周血细胞水平较初诊患者组和复发、难治患者组升高,差异有统计学意义(P<0.05);但不同ISS分期的MM患者外周血细胞表达差异无统计学意义(P>0.05);而进展期MM患者中,CD4+CD25+CD127low/-T细胞表达在Ⅲ期高于Ⅰ期+Ⅱ期,差异有统计学意义(P<0.05);进一步研究发现,同一初诊MM患者骨髓CD4+CD25+CD127low/-T细胞水平低于其外周血T细胞水平,差异有统计学意义(P<0.05).结论 外周血CD4+CD25+CD127low/-T细胞表达异常可辅助鉴别良、恶性单克隆丙种球蛋白血症;监测MM的进展以及疾病的活跃程度,并为进展期MM患者及时进行临床干预提供实验依据.

Correlation between abnormal expression of CD4+CD25+CD127low/-regulatory T cells and multiple myeloma

Objective To investigate the correlation between CD4+CD25+CD127low/-regulatory T cells and the occurrence and development of multiple myeloma(MM).Methods 33 cases of patients with MM,44 cases with The ratio of CD4+CD25+CD127low/-Treg cells in peripheral blood from 33 patients with MM,44 patients with monoclonal gammopathy of undetermined significance(MGUS) and 30 cases of age-matched healthy subjects(control group) were enrolled and detected for CD4+,CD25+ and CD127low/-Treg cells by flow cytometry method and detected for serum level of albumin(Alb) and β2-microglobulin(β2-MG) by using bromocresol green method and transmission turbidimetry respectively.Results Frequency of CD4+CD25+CD127low/-Treg cells were higher in MGUS group and control group than control group(P<0.05).The proportion of CD4+CD25+CD127low/-Treg cells was significantly higher in stable MM than in relapsed or refractory MM and newly diagnosed MM(P<0.05).The expression of CD4+CD25+CD127low/-Treg cells was not statistical different between patients with MM at different International Staging System(ISS) stages(P>0.05),while in patients with active MM,there was a trend of increasing of Treg cell numbers in the ISS stage Ⅰ and stage Ⅱ versus stage Ⅲ(P<0.05).Further more,in patients with newly diagnosed MM,the numbers of Treg cells in bone marrow was lower than in their peripheral blood(P<0.05).Conclusion Detection of CD4+CD25+CD127low/-Treg cells in peripheral blood could be useful for identifying the benign or malignant monoclonal gammopathy,monitoring the progression and activity of MM and offering experimental data to clinical interventions for patients with active MM.