Vascular endothelial growth factor blockade reduces intratumoral regulatory T cells and enhances the efficacy of a GM-CSF-secreting cancer immunotherapy.

PURPOSE: The purpose of the present study was to evaluate granulocyte macrophage colony-stimulating factor (GM-CSF)-secreting tumor cell immunotherapy in combination with vascular endothelial growth factor (VEGF) blockage in preclinical models. EXPERIMENTAL DESIGN: Survival and immune response were monitored in the B16 melanoma and the CT26 colon carcinoma models. VEGF blockade was achieved by using a recombinant adeno-associated virus vector expressing a soluble VEGF receptor consisting of selected domains of the VEGF receptors 1 and 2 (termed sVEGFR1/R2). Dendritic cell and tumor infiltrating lymphocyte activation status and numbers were evaluated by fluorescence-activated cell sorting analysis. Regulatory T cells were quantified by their CD4+CD25hi and CD4+FoxP3+ phenotype. RESULTS: The present study established that GM-CSF-secreting tumor cell immunotherapy with VEGF blockade significantly prolonged the survival of tumor-bearing mice. Enhanced anti-tumor protection correlated with an increased number of activated CD4+ and CD8+ tumor-infiltrating T cells and a pronounced decrease in the number of suppressive regulatory T cells residing in the tumor. Conversely, overexpression of VEGF from tumors resulted in elevated numbers of regulatory T cells in the tumor, suggesting a novel mechanism of VEGF-mediated immune suppression at the tumor site. CONCLUSION: GM-CSF-secreting cancer immunotherapy and VEGF blockade increases the i.t. ratio of effector to regulatory T cells to provide enhanced antitumor responses. This therapeutic combination may prove to be an effective strategy for the treatment of patients with cancer.     

T regulatory cell markers in oral squamous cell carcinoma: Relationship with survival and tumor aggressiveness

Tumor-infiltrating lymphocytes (TILs) are a heterogeneous cell family which plays an important role in tumor-associated immune response. Of these, T regulatory (Treg) cells have also been shown to inhibit anti-tumor response. We aimed to evaluate the expression of T regulatory cell markers (CD4, CD25, CTLA-4 and FoxP3) in samples of oral cavity squamous cell carcinoma (OCSCC) and lip SCC (LSCC) by immunohistochemistry. The relationship of Treg markers with survival data and the proliferative index were also evaluated. We observed similar numbers of CD4-, CD25- and FoxP3(+) cells in OCSCC and LSCC. On the other hand, numbers of CTLA-4(+) cells were significantly lower in OCSCC than in LSCC. OCSCC samples with high numbers of CD4 exhibited a high proliferative index, while samples with high CTLA-4 counts demonstrated a low tumoral proliferative index. A log-rank test showed that patients with OCSCC that presented high counts of CD4 showed a significantly decreased survival compared with patients with low cell counts. In contrast, high CD25(+) cell counts were associated with increased survival. Our results suggest an association of CD4 with poor prognosis, while CD25 expression is related with favorable prognosis. These findings result from the heterogeneity of TIL subsets that display an antagonistic role in tumor immune cell response.     

CD4~+ CD25~+调节性T细胞及其在肿瘤免疫治疗中的意义

CD4+CD25+调节性T细胞是具有独特免疫调节功能的T细胞亚群。近年来研究发现各种恶性肿瘤患者外周血及肿瘤环境中该细胞比例增加,去除CD4+CD25+调节性T细胞或封闭其抑制功能可以增强抗肿瘤免疫反应。CD4+CD25+调节性T细胞成为肿瘤免疫治疗的新靶点。     

CD4+CD25+调节性T细胞对晚期肺癌患者免疫抑制作用的研究

目的 探讨Treg及Th1/Th2类细胞因子在晚期肺癌肿瘤免疫抑制中的作用.方法 选取100例初治晚期肺癌患者及50例健康自愿者.采用流式细胞术检测其外周血中Treg、Th1类细胞因子(IFN-γ、IL-2、TNF-a)、Th2类细胞因子(IL-4、IL-6、IL-10)水平,同时分析CD4+CD25+Treg与Th1/Th2类细胞因子之间的相关性.结果 ①晚期肺癌患者外周血中Treg为(11.12±5.83)%,高于健康对照组(7.46±3.07)%,差异有统计学意义(P=0.003);②化疗前肺癌患者外周血中Treg为(11.12±5.83)%,明显高于化疗后(6.45±3.74)%,差异有统计学意义(P<0.001);③晚期肺癌患者与正常对照组Th1/Th2类细胞因子水平分别为:IFN-γ(8.56±3.62 vs 10.79±3.27,P=0.049)、IL-2(8.48±2.87 vs 10.22±4.03,P=0.03)、TNF-a(6.18±2.67vs8.14±2.87,P=0.007)、IFN-γ/IL-4(3.33±1.44 vs 4.09±1.00,P=0.028)、IL-4(3.17±1.19 vs 2.45±0.43,P<0.001)、IL-6(3.88±2.08 vs 2.33±0.88,P<0.001)、IL-10(3.64±1.73 vs 2.54±1.08,P=0.008),其中Th2类因子水平明显升高,差异有统计学意义(P均<0.05);④CD4+CD25+Treg与Th1类细胞因子IFN-γ、TNF-a、IL-2及IL-6无相关性(P均>0.05);与Th1/Th2(γ=-0.273,P=0.003)呈负相关;与Th2类细胞因子IL-4(γ=0.237,P=0.009)、IL-10(0.626,P<0.001)呈正相关(P均<0.05).结论 晚期肺癌患者CD4+CD25+Treg、Th2类细胞因子水平显著升高,Th1类细胞因子水平下降,它们共同导致肿瘤患者免疫抑制及肿瘤进展,监测其水平变化有助于判断肺癌患者疗效、预后,有效调控CD4+CD25+Treg及负性细胞因子水平可能是治疗肺癌的一个新策略.     

CD4~+CD25~+调节性T细胞与抗肿瘤免疫

CD4~+CD25~+调节性T(CD4~+CD25~+Tr)细胞是一类维持机体自身耐受的T细胞亚群,分布广泛,但不同组织表型有所不同。它们可由胸腺自然产生,也可在外周血中诱导产生,其活化要依赖于特异性抗原的存在。CD4~+CD25~+Tr细胞发挥抑制效应是通过细胞接触依赖或分泌细胞因子这两种方式。去除CD4~+CD25~+Tr细胞或抑制其功能,重新募集效应性T细胞能够增强机体抗肿瘤作用,这将成为一种可行的肿瘤免疫治疗方法。     

Enhanced functionality of CD4+CD25(high)FoxP3+ regulatory T cells in the peripheral blood of patients with prostate cancer

PURPOSE: CD4+CD25(high)FoxP3+ regulatory T cells (Treg) have been shown to inhibit the activation and function of T cells that participate in antigen-specific immune responses. Higher levels of Tregs have been reported in the peripheral blood of patients with several types of tumors. In this study, we investigated the number and functionality of CD4+CD25(high)FoxP3+ Tregs in patients with prostate cancer (PCa), and their potential role in inhibiting antitumor immune responses. EXPERIMENTAL DESIGN: Levels of Tregs in the peripheral blood of healthy donors and patients with biochemically progressive, localized, and metastatic PCa were each measured by flow cytometry. The functional activity of Tregs was determined by their ability to suppress the proliferation of CD4+CD25- T cells. Data were analyzed using Wilcoxon rank sum test and unpaired Student's t test. RESULTS: Although levels of Tregs in the peripheral blood of patients with PCa were not significantly higher than those in healthy donors, Tregs in patients with PCa had significantly greater suppressive functionality than Tregs from healthy donors (P < 0.05). Additionally, there was a direct correlation between the serum levels of prostaglandin E(2) and Treg functionality in patients with localized PCa, using Pearson's product-moment correlation coefficient (R). CONCLUSIONS: These findings further show the potential importance of Tregs in modifying immune responses in patients with PCa. Although longer studies are necessary to confirm these findings, these studies also show for the first time the differences in Treg populations in patients with various stages of PCa, and thus, provide a basis for determining which PCa patient populations are best suited for immunotherapy trials involving the inhibition of Tregs.     

监测肾癌患者外周血CD4~+CD25~+调节性T细胞在术后免疫治疗中的作用

目的:探讨肾癌患者外周血CD4+CD25+T淋巴细胞的监测在术后辅助免疫治疗中的作用。方法:将24例肾癌患者随机分为两组:A组,根治性肾切除术后行IFN-α辅助免疫治疗;B组,单纯行根治性肾切除术;C组,10例健康对照。分别在术前、术后1周以及术后3个月免疫治疗结束时采集外周血样本,流式细胞仪检测CD4+、CD8+、CD4+CD25、CD4+CD25high T淋巴细胞亚群含量,并计算各部分比值。结果:A、B组术前CD4+CD25+、CD4+CD25high T淋巴细胞亚群总体上增加,并且其含量随肿瘤分期的进展而增加(P<0.05),但部分患者并不高于健康对照组。免疫治疗后,肾癌患者CD4+CD25+T淋巴细胞总体略有上升,但术前较高的患者中,约2/3下降。结论:利用流式细胞仪监测肾癌患者外周血CD4+CD25+T淋巴细胞亚群可反映机体抗肿瘤免疫状态,有助于预测免疫治疗的预后,为肾癌尤其是早期肾癌术后辅助免疫治疗的选择提供参考。     

DC-CIK对胃癌合并腹水患者外周血CD4+CD25+调节性T细胞增殖及功能的影响

目的:探讨DC-CIK对胃癌合并腹水患者外周血CD4+CD25+调节性T胞(Treg细胞)比例及功能的影响。方法:60例胃癌合并腹水患者,于输注DC-CIK前1天及DC-CIK治疗结束后1周分别采集外周血。流式细胞术检测外周血Treg细胞的比例,RT-PCR法检测其Foxp3mRNA表达情况;将分选出的Treg细胞和CD4+CD25-T细胞分为单纯Treg细胞组（A组）、1∶1混合培养（B组）、单纯CD4+CD25-细胞组（C组）进行培养,3H-TdR掺入法检测Treg细胞抑制CD4+CD25-细胞增殖的能力。结果:治疗后外周血Treg细胞占CD4+T细胞的比例较疗前显著下降［(6.21±1.37)% vs (9.38±1.06)%,P＜0.05］。治疗后Treg细胞Foxp3mRNA表达水平较治疗前显著下降［(56.18±13.25)% vs (85.26±11.58)%,P＜0.05］。治疗后Treg对CD4+CD25-T细胞抑制增殖能力较治疗前明显下降［(37.31±4.16)% vs (48.92±5.25)%,P＜0.05］。结论:输注DC-CIK免疫治疗,可显著降低胃癌合并腹水患者外周血Treg细胞比例,下调Foxp3mRNA表达水平,降低Treg细胞免疫抑制功能,有利于诱导抗肿瘤免疫效应。     

胃癌患者调节性T细胞胞内外细胞因子的检测及其意义

背景与目的:目前认为CD4 CD25 调节性T细胞与胃癌患者的免疫功能抑制密切相关,但CD4 CD25 调节性T细胞发挥免疫抑制功能的作用机制并不十分清楚.本研究通过检测胃癌患者CD4 CD25 调节性T细胞产生具有不同生物活性的细胞因子干扰素-γ(interferon-γ,IFN-γ)、白介素4(interleukin-4,IL-4)、IL-10及肿瘤生长因子-β(tumor growth factor-β,TGF-β)的分泌情况,进一步探讨这些细胞因子在胃癌患者CD4 CD25 调节性T细胞发挥免疫抑制功能的作用.方法:按常规方法制备患者外周血单个核淋巴细胞,采用免疫磁珠分选方法分离CD4 CD25 T细胞及CD4 CD25-T细胞后,用细胞内细胞因子染色法及ELISA法分别研究CD4 CD25 T细胞在胞内及胞外产生具有不同生物活性的细胞因子IFN-γ、IL-4、IL-1O及TGF-β的水平.结果:(1)与健康对照组比较,胃癌患者分泌内细胞因子IFN-γ、IL-4及IL-10的CD4 CD25 T细胞占CD4 细胞的百分比均显著增高(P＜0.05).(2)培养96 h后,上清液的各种细胞因子水平,无论是胃癌患者还是健康对照组,CD4 CD25 T细胞分泌的IL-10及TGF-β均显著高于CD4 CD25-T细胞(P＜0.05).CD4 CD25 T细胞分泌的IFN-γ显著低于CD4 CD25-T细胞(P＜0.05).结论:CD4 CD25 调节性T细胞体外免疫抑制作用的发挥可能与一些抑制性细胞因子有关,特别是细胞因子TGF-β在胃癌CD4 CD25 调节性T细胞的免疫抑制功能中起着相当重要的作用.     

Different mechanisms for anti-tumor effects of low- and high-dose cyclophosphamide

It is known that, besides its direct cytotoxic effect as an alkylating chemotherapeutic agent, cyclophosphamide also has immuno-modulatory effects, such as depletion of CD4+CD25+ regulatory T cells. However, its optimal concentration has not yet been fully elucidated. Therefore, we first compared the effects of different doses of cyclophosphamide on T cell subsets including CD4+CD25+ T cells in mice. Cyclophosphamide (20 mg/kg) decreased the numbers of splenocytes, CD4+ and CD8+ T cells by approximately 50%, while a decline in CD4+CD25+ T cell number was more profound, leading to the remarkably lower ratios of CD4+CD25+ T cells to CD4+ T cells. In contrast, 200 mg/kg cyclophosphamide severely decreased the numbers of all the T cell subsets by > 90% although the decreased ratios of CD4+CD25+ T cells to CD4+ T cells were still observed. Next, low-dose cyclophosphamide significantly inhibited in vivo growth of murine hepatoma MH129 tumor in immuno-competent but not immuno-deficient mice. This anti-tumor effect was abolished by CD4+CD25+ T cell repletion. In contrast, high-dose cyclophosphamide exhibited similar anti-tumor effects in both mice. In addition, contrary to antibody-mediated CD4+CD25+ T cell depletion, administration of low-dose cyclophosphamide after tumor inoculation was more efficacious than the prior administration. Our data show that low-dose cyclophosphamide selectively depletes CD4+CD25+ T cells, leading to enhanced anti-tumor effects against pre-existing tumors, while the anti-tumor effect of high-dose cyclophosphamide is solely attributed to its direct cytotoxicity. These findings appear to be highly crucial in a clinical setting of combined chemotherapy and immunotherapy for cancer treatment.     

结直肠癌患者外周血CD4+ CD25high调节性T细胞的作用

目的探讨结直肠癌患者外周血CD4+CD25high调节性T细胞(Treg)的作用。方法采用流式细胞仪测定36例结直肠癌患者及30例健康对照者外周血中CD4+CD25highFoxP3 Treg、CD4+CD25highTreg、CD4+CTLA-4 Treg及CD4+T细胞水平。结果与健康对照组比较,结直肠癌组患者外周血CD4+CD25highFoxP3 Treg显著增多(P<0.01),CD4+CD25high Treg和CD4+CTLA-4 T细胞也增多(P<0.05)。结论CD4+CD25highFoxP3 Treg可能在结直肠癌发展过程中起着重要作用。     

CD4+CD25+调节性T细胞与大肠癌的关系

近来CD4 CD25 调节性T细胞对肿瘤免疫调节的抑制作用正受到越来越多的重视,许多恶性肿瘤患者外周血都存在CD4 CD25 调节性T细胞比例上调,机体抗肿瘤免疫力下降.大肠癌的发病率正逐年上升,其发病分子机制已为熟知,免疫机制研究不多,国内尚未见大肠癌与该类细胞关系的报道,现对CD4 CD25 调节性T细胞在大肠癌的发生、发展、治疗中的研究综述如下.     

肿瘤患者外周血调节性T细胞的检测及临床意义

目的:研究肿瘤患者外周血调节性T细胞水平的变化并探讨其临床意义,旨在了解肿瘤患者的免疫功能改变,为肿瘤患者临床治疗及判断预后提供依据。方法:采用流式细胞仪对40例肿瘤患者及40例正常人外周血CD4+CD25+T细胞、CD4+CD25highT细胞及CD4+CD25+Foxp3+Treg细胞水平进行检测。结果:肿瘤患者外周血中CD4+CD25+T细胞和CD4+CD25highT细胞高于正常对照组(P<0.05);CD4+CD25+Foxp3+调节性T细胞亦明显高于对照组(P<0.01)。结论:肿瘤患者细胞免疫功能明显异常,CD4+CD25+Foxp3+调节性T细胞增多可能是肿瘤患者免疫功能受抑的重要原因之一;调节性T细胞水平检测在评价肿瘤患者疗效及判断预后方面具有一定的临床价值。     

CD4+CD25+ regulatory T cells in patients with gastrointestinal malignancies: possible involvement of regulatory T cells in disease progression

BACKGROUND: Active suppression by CD4+CD25+ regulatory T cells plays an important role in the down-regulation of the response of T cells to foreign and self antigens. Experimental tumor models in mice revealed that regulatory T cells inhibit antitumor immune responses. The purpose of the current study was to demonstrate the possible involvement of CD4+CD25+ regulatory T cells in immune system impairment in patients with gastrointestinal malignancies. METHODS: The phenotypes of lymphocytes, particularly those of CD4+CD25+ T cells, were analyzed in peripheral blood in 149 patients with gastrointestinal malignancies and in ascites in 7 patients with peritoneal dissemination. In addition, cytokine production after in vitro stimulation was examined in CD4+CD25+ and CD4+CD25- T cells isolated from patients with malignant disease. RESULTS: Compared with healthy volunteers, patients with gastrointestinal malignancies had a higher proportion of CD4+CD25+ T cells in peripheral blood, due to the presence of a drastically smaller number of CD4+CD25- T cells. Among patients with gastric carcinoma, those with higher percentages of CD4+CD25+ T cells had a poorer prognosis than did those with lower percentages. CD4+CD25+ T cells also were present in greater proportions in ascites from patients who had advanced-stage disease with peritoneal dissemination. Isolated CD4+CD25+ T cells from patients with malignant disease produced interleukin (IL)-4 and IL-10 but not IL-2 or interferon-gamma; these cells also inhibited cytokine production by CD4+CD25- T cells after in vitro stimulation. CONCLUSIONS: The relative increase in CD4+CD25+ regulatory T cells may be related to immunosuppression and tumor progression in patients with gastrointestinal malignancies. This finding suggests that the use of immunomodulatory therapy to treat patients with gastrointestinal malignancies may be an effective strategy.     

CD4+FoxP3+ regulatory T cells gradually accumulate in gliomas during tumor growth and efficiently suppress antiglioma immune responses in vivo

The suppressive activity of regulatory T cells (Treg) has been implicated as an important factor limiting immune mediated destruction of tumor cells. However, not much is known about the presence and function of Treg within tumors. Here we show in a syngeneic murine glioma model a time-dependent accumulation of CD4+FoxP3+ Treg in brain tumors. Further analysis revealed a time-dependent upregulation of CD25, CTLA-4, GITR and CXCR4 on intratumoral CD4+FoxP3+ Treg during tumor growth. Moreover, freshly isolated intratumoral Treg were highly suppressive when tested directly ex vivo. Treatment with anti-CD25 monoclonal antibodies (mAbs) significantly reduced the number of these highly suppressive CD4+FoxP3+ cells within the growing tumor and provoked a CD4 and CD8 T cell dependent destruction of the glioma cells. Combining Treg depletion with administration of blocking CTLA-4 mAbs further boosted glioma-specific CD4+ and CD8+ effector T cells as well as antiglioma IgG2a antibody titers resulting in complete tumor eradication without any signs of autoimmunity. These data illustrate that intratumoral accumulation and activation of CD4+FoxP3+ Treg act as a dominant immune escape mechanism for gliomas and underline the importance of controlling tumor-infiltrating Treg in glioma immunotherapy.     

Imatinib impairs the proliferation and function of CD4+CD25+ regulatory T cells in a dose-dependent manner

The tyrosine kinase inhibitor imatinib has been reported to inhibit CD8+ T lymphocytes. Little is known about its effects on CD4+CD25+ regulatory T cells (T(reg) cells) which might regulate the graft-vs.-leukemia (GVL) reaction after allogeneic stem cell transplantation (allo-SCT) and donor lymphocyte infusion (DLI). This is of particular interest in patients with relapse of chronic myeloid leukemia (CML) after allo-SCT, as the two therapeutical options DLI and imatinib might interact reversely. Here, we demonstrate that the proliferation of CD4+CD25+ T(reg) cells and their production of IL-10, TGF-beta1 and granzyme B as markers of activation were significantly down-regulated by imatinib in a dose-dependent manner. In addition, the expression of surface CD69, both surface and intracellular GITR, FoxP3, CD152 (CTLA) of activated CD4+CD25+ T(reg) cells were inhibited by imatinib in a dose-dependent manner. In light of these findings, clinical administration of imatinib might not result in a reduction of the GVL effect on CML patients receiving imatinib after allo-SCT and/or DLI or other CD8+ T lymphocyte based immunotherapies as the function of CD8+ cytotoxic T lymphocytes and CD4+CD25(hi) Treg cells is hampered in a similar way by imatinib.     

肝癌荷瘤小鼠调节性T细胞数量的改变及其与肿瘤生长的关系

目的研究肝癌荷瘤小鼠调节性T细胞数量的改变及其与肿瘤生长的关系。方法采用小鼠肝癌细胞系H22接种BALB／c小鼠,建立肝癌模型;采用流式细胞术方法检测CD4^＋ CD25^＋T／CD4^＋T细胞的比例;以RT-PCR和流式细胞术检测Foxp3基因的表达。以免疫磁珠分选法纯化CD4^＋CD25^＋T和CD4^＋CD25^-T细胞;在体外,用3H-TdR掺入法检测T细胞的增殖情况;在体内,观察荷瘤小鼠来源的CD4^＋CD25^＋T细胞对肿瘤生长的作用。结果（1）荷瘤小鼠在引流淋巴结中,CD4^＋CD25^＋T细胞占CD4＋T细胞（18．80％±0．06％）比例增高,与对照组（9．50％±0．03％）相比,差异有统计学意义（P〈0．01）;在非引流淋巴结（LN）和脾脏（SP）中,荷瘤小鼠CD4^＋CD25^＋T／CD4^＋T比例分别为16．28％±0．02％和17．28％±0．06％,与对照组9．50％±0．03％和11．08％±0．04％相比,差异有统计学意义（P〈0．01,P〈0．05）;同时,调节性T细胞特异性标志Foxp3 mRNA的表达也升高。在同一只荷瘤小鼠中,引流淋巴结中CD4^＋CD25^＋T细胞数量（18．8％±0．06％）较对侧非引流淋巴结（16．28％±0．02％）略有升高,但差异无统计学意义（P〉0．05）。（2）从荷瘤小鼠中纯化的CD4^＋CD25^＋T细胞,在体外对抗CD3单抗的刺激无反应,但能抑制CD4^＋CD25^-T细胞的增殖。（3）CD4^＋CD25^＋T／CD4＋T比例与肿瘤大小呈正相关,并且可以抑制CD4^＋CD25^-T细胞的抗肿瘤效应。结论肝癌细胞在小鼠体内的生长可以提高调节性T细胞的数量,其数量的高低与肿瘤的大小呈正相关,提示清除调节性T细胞将是肿瘤免疫治疗的策略之一。     

Activation of central/effector memory T cells and T‐helper 1 polarization in malignant melanoma patients treated with anti‐programmed death‐1 antibody

Human anti‐programmed death‐1 (PD‐1) antibody possesses the capability to revitalize host T cells and has been an effective therapy for metastatic malignant melanoma (MM). The precise subsets of T cells predominantly activated by anti‐PD‐1, however, have not yet been clarified. In this study, peripheral blood mononuclear cells obtained from MM patients scheduled to receive anti‐PD‐1 (nivolumab) therapy, and healthy subjects (HS), were systematically examined on flow cytometry to identify changes in the proportion of immune cell subsets. Compared with HS, MM patients prior to therapy had an increased proportion of activated CD8+ T cells with effector memory phenotypes (Tem), and PD‐1 positive subsets of CD4+ central memory T cells (Tcm) and T‐helper (Th)17 cells. After a single course of anti‐PD‐1 therapy, MM patients had an increase in activated Tem and Tcm subsets of CD4+ and CD8+ T cells, and activated Th1 plus T‐helper follicular 1 cells. There was no consistent change in the proportion of Tfh cells, B cells, natural killer cells, or dendritic cells. The observed activated phenotypes were attenuated during the course of therapy, but regulatory T cells belonging to the CD3+CD4+CD45RO+CD25high fraction increased at disease progression. Taken together, anti‐PD‐1 therapy modulates systemic immune reactions and exerts anti‐tumor effects, not only by revitalizing Tem and Tcm of CD4+ and CD8+ T cells, but also via a shift to a Th1 phenotype.     

原发性肝癌患者CD4+CD25+CD127low调节性T细胞的检测及意义

探讨CD4+CD25+CD127low调节性T细胞（Tregs）在原发性肝细胞性肝癌（HCC）患者外周血中的变化及其临床意义。方法:采集40例乙型肝炎病毒（HBV）相关的HCC患者［巴塞罗那临床肝癌（BCLC）分期A期患者7例、B期患者8例、C期患者20例、D期患者5例］、35例慢性乙型肝炎（CHB）患者及28例正常健康人的外周抗凝血,应用CD4（PE-CY5）、CD25（FITC）、CD127（PE）三种特异性荧光抗体标记后,通过流式细胞术对CD4+CD25+CD127lowTregs水平进行三色荧光抗体检测。结果:HCC患者外周血CD4+CD25+CD127lowTregs占CD4+T细胞的百分比显著高于正常健康人（P<0.001）和CHB患者（P=0.017）,CHB患者外周血CD4+CD25+CD127lowTregs占CD4+T细胞的百分比高于正常健康人（P=0.035）;HCC中BCLC分期为C期的患者外周血CD4+CD25+CD127lowTregs占CD4+T细胞的百分比显著高于A期患者（P=0.020）和B期患者（P=0.019）。结论:CD4+CD25+CD127lowTregs水平异常增高可能是HCC免疫逃逸的一个重要机制,且其变化水平与临床病情的进展存在一定的相关性。