急性髓系白血病患者T淋巴细胞内细胞因子表达特性

T淋巴细胞在抗肿瘤的免疫反应中起着重要作用，而大部分肿瘤患者往往存在免疫功能低下。本研究通过对急性髓系白血病（AML）患者T淋巴细胞胞内细胞因子特性的研究，以了解AML患者在不同状态下T淋巴细胞的功能。18例不同状态下初诊AML患者和10例健康成人外周血中的T淋巴细胞在莫能霉素存在的情况下，体外经PMA和离子霉素（ionomycin）刺激后，分别进行CD4-FITC、CD8-FITC荧光单克隆抗体染色和IFNγ-PE、IL4-PE荧光单克隆体胞内染色，最后进行流式细胞仪分析。结果表明：初诊AML患者中CD4^＋和CD8^＋T淋巴细胞胞内IFNγ分泌水平均明显低于健康成人外周血T淋巴细胞，CD4^＋和CD8^＋T细胞胞内IL-4分泌水平与成人外周血细胞无显著差异。处于临床缓解状态的AML患者，CD8^＋T淋巴细胞刺激后胞内产生IFNγ的量明显高于初诊AML患者（P〈0、05）．但与健康成人无显著差异（P〉0、05）。复发的AML患者外周血中CD4^＋T细胞和CD8^＋T细胞刺激后胞内产生IFNγ量明显低于健康成人外周血T淋巴细胞以及处于完全缓解状态的AML患者CD8^＋T淋巴细胞（P〈0、05）．而IL-4的量明显高于健康成人和初诊AML患者CD4^＋T细胞和CD8^＋T细胞（p〈0．05）。结论：处于不同状态下的AML患者T细胞亚群分泌的细胞因子发生了改变，与之相应的是，初次诊断的AML患者外周血中CD4‘和CD8’T淋巴细胞刺激后Th1／Tcl细胞反应低下，Th2／Tc2细胞反应与健康成人T淋巴细胞无差异；完全缓解状态的AML患者T细胞Thl反应虽然仍低下，但Tcl反应明显增强，与健康成人无差异；复发的AML患者CD4^＋和CD8^＋T细胞Th2／Tc2样反应较Thl／Tcl样反应明显增强。

Intracellular Cytokine Expression Characteristics of Activated T Lymphocytes in Patients with Acute Myeloid Leukemia

T lymphocytes are an integral part of the effective immune response against various tumors, but they are frequently functionally unresponsive in tumor-bearing patients. This study was aimed to investigate the T lymphocyte function of patients with acute myeloid leukemia (AML) in different status through analyzing intracellular cytokine characteristics of T lymphocytes in AML patients. The T lymphocytes from 18 de nuevo AML patients in different status and 10 healthy controls were stimulated with phorbol 12-myristate 13-acetate (PMA) and ionomycin in the presence of monensin, and were stained with fluorescent McAbs CD4-PITC, CD8-FITC and IFNgamma-PE, ILA-PE, then their T lymphocytes were analyzed by flow cytometry. The results showed that IFN-gamma level in CD4+ and CD8+ T cells of de novo AML patients was significantly lower as compared with healthy controls (p<0.05), while IL-4 level in CD4+ and CD8+ T cells was low too, there was no significant difference between de novo AML patients and healthy controls. In AML patients in clinical remission, IFNgamma level in CD8+ T cells was significantly higher than that in de novo AML patients (p<0.05), but there was no significant difference as compared with healthy controls (p>0.05). In relapsed AML patients, IFNgamma level in CD4+ and CD8+ T cells was significantly lower than that in healthy controls and in AML patients with CR (p<0.05), while IL-4 level was significantly higher than that in healthy controls and de nuevo AML patients (p<0.05). It is concluded that the cytokine secretion in T cell subsets of AML patients in different status is changed. Correspondingly, the Th1/Tc1 level is low after stimulating CD4+ and CD8+ T cells in peripheral blood of de novo AML patients, but not different from healthy controls. Though the Th1 level in T cells of AML patients in complete remission is low, but Tc1 response is even enhanced as high as the healthy controls. The Th2/Tc2-like response of CD4+ and CD8+ T cells in relapsed AML patients obviously increases when compared with Th1/Tc1-like response.