儿童急性淋巴细胞性白血病细胞内IL-6IFN-γ水平变化及其临床意义

目的：了解急性淋巴细胞性白血病(acutelymphoblasticleukemia,ALL)在不同病期单个核细胞内白细胞介素-6(interleukin-6,IL-6)、γ-干扰素(interferon-γ,IFN-γ)水平变化规律,并探讨不同病期ALL患儿IL-6与IFN-γ之间相关关系,以期为临床开展细胞因子等细胞生物学方法治疗白血病提供一定依据。方法：采用流式细胞仪活细胞直接/间接免疫荧光法测定42例ALL患者初发期及缓解期静脉血经培养和刺激后单个核细胞内IL-6及IFN-γ的表达水平。20例健康儿童作为正常对照。结果：①ALL患儿初发期其静脉血单个核细胞内IL-6表达水平为81.74±9.31,较正常对照组的5.67±0.96明显升高(P<0.01),而静脉血单个核细胞内IFN-γ表达水平为1.31±0.32,较正常对照组的1.46±0.49有所下降(P<0.01);经化疗获得缓解后,ALL患者静脉血单个核细胞内IL-6表达水平为27.52±3.40,较初发期明显降低(P<0.01),却仍较正常对照组升高(P<0.01),而静脉血单个核细胞内IFN-γ表达水平为1.97±0.72,较初发期明显升高(P<0.01),且较正常对照组也明显升高,(P<0.01)。②ALL患儿不同病期静脉血单个核细胞内IL-6与IFN-γ表达呈明显的负相关(r=-0.476,P<0.05)。结论：ALL患儿静脉血单个核细胞内IL-6水平与其病情是否缓解有着密切的关系,ALL治疗中单个核细胞内IL-6水平下降表示ALL可能获得缓解。当ALL患者经化疗获得缓解时,IFN-γ的水平增高,但二者相互作用机制及其与ALL患者所处病期的因果关系还有待进一步阐明。

Levels of intracellular IL-6 and IFN-γ in children with acute lymphoblastic leukemia

OBJECTIVE: To study the changes of intracellular interleukin-6 (IL-6) and interferon-gamma (IFN-gamma) expressions in children with acute lymphoblastic leukemia (ALL) at different stages, and to examine the correlation between IL-6 and IFN-gamma in ALL children. METHODS: The levels of intracellular IL-6 and IFN-gamma in venous blood lymphocytes were detected by flow cytometry in 42 children with ALL at diagnosis and at remission stage. Twenty healthy children were used as the controls. RESULTS: The intracellular IL-6 level in ALL children at diagnosis was 81.74+/-9.31, which was much higher than that in the Control group (5.67 +/- 0.96 ) (P < 0.01). The intracellular IFN-gamma level in ALL children (1.31 +/- 0.32) was significantly lower than that in the Control group (1.46 +/- 0.49) (P < 0.01). However, the intracellular IL-6 level (27.52 +/- 3.40) decreased remarkably in ALL patients at remission stage (P < 0.01), but was still higher than that in the Control group (P < 0.01). In contrast, the intracellular IFN-gamma level (1.97 +/- 0.72) increased noticeably in ALL patients at remission stage, which was higher than that at diagnosis and the Control group (P < 0.01). A negative correlation was found between the intracellular IL-6 and the IFN-gamma levels in ALL patients (r=-0.476, P < 0.05). CONCLUSIONS: Intracellular IL-6 and IFN-gamma levels may be used as the markers for monitoring the response to treatment in ALL patients. There is a negative correlation between intracellular IL-6 and IFN-gamma levels in ALL children.