再生障碍性贫血患者免疫调节剂治疗前后TNF和IL-2水平变化及意义

为了探讨再生障碍性贫血(AA)的免疫发病机理及抗T淋巴细胞单克隆抗体(McAb-T)的免疫调节治疗作用,采用放射免疫分析法检测30例AA患者McAb-T治疗前后血清肿瘤坏死因子(TNF)和白细胞介素-2(IL-2)水平及其中10例AA外周血单个核细胞(PBMNC)体外诱生TNF和IL-2水平的变化。结果表明,治疗前AA患者血清TNF水平显著增高(p<0.01),PBMNC诱生的TNF和IL-2水平均明显高于正常对照(p<0.01)。治疗后血清TNF和PBMNC诱生的TNF和IL-2水平降低,与对照组比较无显著差异(p>0.05)。提示AA患者存在造血调控因子分泌异常,McAb-T对TNF和IL-2能发挥特异性的免疫调节作用。

CHANGES OF SERUM TNF AND IL_(-2) LEVELS IN APLASTIC ANEMIA PATIENTS BEFORE AND AFTER TREATMENT WITH IMMUNOMODULATOR

The aim of this study was to investigate the immune pathogeny and the effect of immunoregulatory therapy with monoclonal anti-human T lymphocyteantibody (McAb-T) on aplastic anemia (AA). The levels of tumor necrosis factor (TNF),interleukin-2 (IL-2) both in serum of 30 patients and in culture supernatant of peripheral blood mononuclear cells (PBMNC) in the presence of pyhtohemagglutinin(PHA)of 10 patients with AA were analysed with radio-immunoassay methods before and after McAb-T therapy. The results showed that before therapy the levels of TNF both in serum and in culture supernatant Of PBMNC were significantly higher than those in normal controls(p<0.01), IL-2 in patient serum was not much different from that in normals controls(p>0.05) but significantly increased in culture supernatant of PBMNC (p<0.01). After therapy the levels of TNF in serum and TNF or IL-2 in culture supernatant of PBMNC were decreased and not much different from normal controls (p>0.05).The abnormal production of hematopoietic regulation cytokines TNF and IL-2 might play an important role in the progression of AA patients. McAb-T could play a specific immunoregulatory role and relieve the inhibitory action, directly or indirectlv.on hematopoiesis by T lymphocytes and relative cytokines.