儿童急性白血病外周血Th17细胞表达及其临床意义分析

摘要：目的　探讨辅助性T细胞17（Th17）细胞表达与儿童急性白血病的发生发展及疾病状态的关系。方法　将2008年8月至2009年12月在华中科技大学同济医学院附属协和医院儿科住院的42例急性白血病患儿分为未缓解组（A组，23例）和缓解组（B组，19例）。18名健康儿童作为对照组（C组）。采用酶联免疫吸附法（ELISA法）检测各组外周血单个核细胞（PBMC）刺激培养上清液中白细胞介素-17（IL-17）和白细胞介素-23（IL-23）的水平，利用流式细胞术分析PBMC中CD4+ IL-17+细胞的比例。结果　A组和B组IL-17和IL-23均低于C组，差异有统计学意义（P < 0.05），A组IL-17低于B组，差异具有统计学意义（P < 0.05），但两组IL-23差异无统计学意义（P ＞ 0.05）。A组和B组Th17的比例均低于C组，且A组Th17低于B组，差异均具有统计学意义（P均< 0.05）。结论　Th17细胞可能通过分泌IL-17参与了儿童急性白血病发生及病情发展，其水平高低部分反映白血病的疾病状态。

Expression and clinical significance of peripheral Th17 cell in children with acute leukemia.

Expression and clinical significance of peripheral Th17 cell in children with acute leukemia.　　WU Xiao-yan，JIN Run-ming，YU Hui，WANG Fang，XIA Yi. Pediatrics Department of Union Hospital，Tongji Medical School，Huazhong University of Science and Technology，Wuhan 430022，ChinaAbstract：Objective　To study the relationship between peripheral blood Th17 cells and the occurrence and status of disease of children with acute leukemia. Methods　From Aug. 2008 to Dec. 2009 in Pediatrics Department of Union Hospital，Tongji Medical School Huazhong University of Science and Technology， 42 children with acute leukemia and 18 healthy children were divided into non-remission group （Group A，n = 23），remission group （Group B，n = 19） and control group （Group C，n = 18）. Concentration of IL-17 and IL-23 in the peripheral blood monocytes culture supernatant after stimulated with anti-CD3 and anti-CD28 mAb were determined with ELISA. Expression of CD4+ IL-17+ cells was determined with flow cytometry. Results　The concentrations of IL-17 and IL-23 in Group A and Group B were much lower than those in Group C（P < 0.05）. The level of IL-17 in Group A was lower than that in Group B（P < 0.05），while the difference of IL-23 concentration between Group A and Group B was not significant（P  > 0.05）. The expression level of Th17 in Group A and Group B were much lower than those in Group C（P < 0.05），and the difference of Th17 expression level between Group A and Group B was significant（P < 0.05）. Conclusion　Th17 cells might play important role in the occurrence and development of children acute leukemia through secreting IL-17，and their function level can partly reflect the status of leukemia and evaluating the risks of infection in children with leukemia.