多发性骨髓瘤患者外周血CD4^＋CD25^high调节性T细胞的变化及意义

目的：通过分析CD4^＋CD25^high曲调节性T细胞（Tregs）在不同分期多发性骨髓瘤（MM）患者外周血中的变化和临床意义,初步探讨MM患者的免疫抑制机制。方法：流式细胞术检测40例MM患者及20例健康志愿者外周血T淋巴细胞亚群、NK细胞及CD4^＋CD25^highghT细胞水平,并进行分层分析。结果：①虽然Ⅱ期MM患者CD3^＋、CD4^＋T细胞与对照组比较差异无统计学意义（P〉0．05）,但CD8^＋T细胞明显升高,CD4／CD8明显降低,均差异有统计学意义（均P〈0．05）;随疾病进展至Ⅲ期,CD3^＋、CD4^＋T细胞及CD4／CD8均明显降低,CD8^＋T细胞明显升高,差异有统计学意义（P〈0．01）;各期NK细胞比例与对照组接近（P〉0．05）。②MM患者各期CD4^＋CD25^highT细胞占总CD4^＋T细胞的比例均高于正常对照组,差异有统计学意义（P〈0．01）。进一步分层分析发现,随疾病进展MM患者CD4^＋CD25^high调节T细胞逐渐增高,Ⅲ期增高最为显著（P〈0．05）。结论：MM患者存在细胞免疫功能异常,CD4^＋CD25^highT细胞在其外周血中比例明显升高,且与疾病进展密切相关,这将为免疫治疗MM提供新的参考。     

活化性杀伤细胞免疫球蛋白样受体阳性的NK细胞对靶细胞的杀伤作用

Objective To study the killing effects of the killer cell immunoglobutin-like receptors (KIR) KIR2DS1-positive natural killer (NK) cells against acute, myeloid leukemia (AML) target cells, and to explore the KIR, human leucocyte antigen-Cw, and Cw loci (HLA-Cw) of NK cells, and, HLA-Cw of target cells mismatches destruction mechanism. Methods High-purified NK cells separated by DNYAL bead negative selection from healthy donor peripheral blood were taken as effector cells, and the freshly isolated bone marrow mononuclear cells from newly diagnosed AML patients as target cells. The anti-CD158a, CD158b monoclonal antibody was used to block inhibitory KLR receptors of NK cells (such as: KIR2DL1, KIR2DL2, KIR2DL3). The NK cells cytotoxicities against target cells before and after KIR blockades were detected by MTT reduction assay in vitro. Polymerase chain reaction and sequence specific primers (PCR-SSP) genotyping techniques were used to detect HLA-Cw, KIR gene of the healthy donors and patients. NK cells and target cells were divided into group C1 (expressing HLA-Cw 01, 03, 07, 08, 12, 14, 16 alleles), C2 group (expressing HLA-Cw 02, 04, 05, 06, 15, 17, 18 alleles) and the C1/C2 group (co-expressing the alleles in C1 group and C2 group) based on HLA-Cw. Results The purity of NK cells analyzed by flow cytometry was (90.8±6.08)%, and the killing effects of NK cells were significantly enhanced after inhibitory KIR blockades (t=-3.00, P=0.005). The cell lysis in C1 group, KIR2DS1+ NK cells against C2 group target cells (57.37±1.40)% was significantly higher than that against C1 group (44.19±4.67) % and C1/C2 group (36.77±6.56)% target cells (F= 11.87, P = 0.021), furthermore the differences in cell lysis among the above three groups become more evident after the inhibitory KIR blockades (F = 18. 72, P=0. 009). Conclusions The activity of NK cells was increased after the inhibitory KIR blockades, and the killing activities of KIR2DS1+ NK cells were higher than KIR2DS1 NK cells. The incompatibility between KIR, HLA-Cw of NK cells and HLA-Cw of target cells mediated NK alloactivation, realizing "missing self" recognition, and enabling NK cells cytotoxieity against targets.     

树突状细胞与肿瘤细胞融合瘤苗研究进展

树突状细胞(DC)与肿瘤细胞融合所获得的杂交瘤细胞，既可内源性表达肿瘤抗原，又具DC抗原递呈能力，能够诱导特异抗肿瘤细胞毒性T淋巴细胞(CTL)，有望成为安全高效的肿瘤疫苗应用于临床。现将其研究进展作一综述。     

陈发性睡眠性血红细胞尿患者测定CD55,CD59的意义

本文采用流式细胞技术测定６例陈发性睡眠性血红蛋白尿（ＰＮＨ）,１１例再障－ＰＮＨ综合征,１０例再生障碍性贫血（ＡＡ）患者外周血淋巴细胞膜ＣＤ５５和ＣＤ５９标记率。６例ＰＮＨ患者均表现出ＣＤ５５和ＣＤ５９下降（Ｐ〈０．０１）,１１例再障－ＰＮＨ综合征患者也表现出ＣＤ５５和ＣＤ５９下降（Ｐ〈０．０５）;１０例再生障碍性贫血患者中８例ＣＤ５５和ＣＤ５９标记率在９５％以上,２例标记率在８５％以上,与对照组     

间充质干细胞对混合淋巴细胞反应体系中T淋巴细胞的免疫调节作用

目的:探讨间充质干细胞(MSC)在体外对T淋巴细胞免疫调节作用的特点。方法:通过Ficoll梯度密度离心法分离出正常人骨髓单个核细胞,体外培养扩增MSC,获取第3代细胞。将其按照不同的比例加入双向混合淋巴细胞培养(MLC)体系中,在第3、5天,采用MTT比色法检测各组MLC中的T淋巴细胞的增殖情况,再用流式细胞术分析其与MSC共孵育前后细胞表面标记的变化情况。结果:加入了MSC的MLC体系中,MSC对T淋巴细胞的增殖抑制具有剂量依赖性,且随着时间延长,抑制程度增强;其中,CD4 T细胞亚群受抑不如CD8 T细胞亚群显著;另外,T淋巴细胞表面CD25的表达虽然较对照组有所下降,但是CD4、CD25共表达的细胞却较对照组有明显的上升趋势。T淋巴细胞表面活化抗原HLA-DR的表达较对照组有轻度减低。结论:MSC在体外能够明显抑制T淋巴细胞的增殖,其主要是针对CD8 T细胞(CTL)。另外,它还能下调活化T淋巴细胞上一些较特异的表面标记CD25和HLA-DR的表达。     

CD4^＋T细胞与肿瘤免疫

CD4^＋T细胞不仅辅助激活CD8^＋T细胞,而且对记忆性细胞毒性T淋巴细胞（CTL）应答的产生和维持起重要作用,并具有直接的抗肿瘤功能。另外CD4^＋CD25^＋调节性T细胞（Tregs）具有免疫负调控功能。在肿瘤免疫抑制及免疫逃逸中发挥重要作用,是肿瘤免疫治疗失败的重要原因。近年肿瘤免疫治疗已获得很大进步,相关肿瘤疫苗的研究也备受关注.     

全反式维甲酸治疗急性早幼粒细胞白血病过程血脂变化的研究

目的:探讨全反式维甲酸(all-trans-retinoic acid, ATRA)治疗急性早幼粒细胞白血病(acute promyelocytic leukemia, APL)过程中血脂含量的变化及可能机制.方法:回顾分析了76例APL患者行ATRA诱导分化治疗过程中血脂水平变化的情况,并同时检测了NB4细胞行ATRA诱导分化过程中培养液上清中血脂水平的变化,以肝癌细胞HepG2和培养液为对照.结果:76例APL患者行ATRA治疗后2周行血清甘油三酯(triglyceride,TG)水平检测,结果显示TG水平较治疗前明显升高(P＜0.01),而胆固醇(cholesterol,TC)水平则治疗前后差异无统计学意义.NB4细胞培养72 h后培养液上清中TG水平明显升高(P＜0.05),NB4细胞在ATRA(0.5 μmol/L)作用0、24、48和72 h后,培养液上清中TG水平逐渐升高(P＜0.01),同样2组细胞培养0,24,48,72 h后,培养液上清中TC水平经检测,水平变化差异无统计学意义.HepG2细胞及HepG2细胞在ATRA (0.5 μmol/L)培养0、24、48和72 h后培养液上清中TG及TC水均无明显变化.结论:ATRA治疗APL过程中可引起高甘油三酯血症,可能与APL细胞代谢有关.     

活化性杀伤细胞免疫球蛋白样受体阳性的NK细胞对靶细胞的杀伤作用

Objective To study the killing effects of the killer cell immunoglobutin-like receptors (KIR) KIR2DS1-positive natural killer (NK) cells against acute, myeloid leukemia (AML) target cells, and to explore the KIR, human leucocyte antigen-Cw, and Cw loci (HLA-Cw) of NK cells, and, HLA-Cw of target cells mismatches destruction mechanism. Methods High-purified NK cells separated by DNYAL bead negative selection from healthy donor peripheral blood were taken as effector cells, and the freshly isolated bone marrow mononuclear cells from newly diagnosed AML patients as target cells. The anti-CD158a, CD158b monoclonal antibody was used to block inhibitory KLR receptors of NK cells (such as: KIR2DL1, KIR2DL2, KIR2DL3). The NK cells cytotoxicities against target cells before and after KIR blockades were detected by MTT reduction assay in vitro. Polymerase chain reaction and sequence specific primers (PCR-SSP) genotyping techniques were used to detect HLA-Cw, KIR gene of the healthy donors and patients. NK cells and target cells were divided into group C1 (expressing HLA-Cw 01, 03, 07, 08, 12, 14, 16 alleles), C2 group (expressing HLA-Cw 02, 04, 05, 06, 15, 17, 18 alleles) and the C1/C2 group (co-expressing the alleles in C1 group and C2 group) based on HLA-Cw. Results The purity of NK cells analyzed by flow cytometry was (90.8±6.08)%, and the killing effects of NK cells were significantly enhanced after inhibitory KIR blockades (t=-3.00, P=0.005). The cell lysis in C1 group, KIR2DS1+ NK cells against C2 group target cells (57.37±1.40)% was significantly higher than that against C1 group (44.19±4.67) % and C1/C2 group (36.77±6.56)% target cells (F= 11.87, P = 0.021), furthermore the differences in cell lysis among the above three groups become more evident after the inhibitory KIR blockades (F = 18. 72, P=0. 009). Conclusions The activity of NK cells was increased after the inhibitory KIR blockades, and the killing activities of KIR2DS1+ NK cells were higher than KIR2DS1 NK cells. The incompatibility between KIR, HLA-Cw of NK cells and HLA-Cw of target cells mediated NK alloactivation, realizing "missing self" recognition, and enabling NK cells cytotoxieity against targets.     

带状疱疹患者外周血T细胞亚群分析

用流式细胞仪检测43例带状疱疹患者外周血T淋巴细胞亚群，与20例正常人对照，结果，带状疱疹组CD3下降（P＜0．05），CD4下降（P＜0．01），CD8有升高趋势，CD4／CD8有下降趋势（皆P＞0.05）。推测CD4降低与带状疱疹发病有直接关系。