IL-17和IL-21在急性白血病患者中的表达及意义

本研究旨在探讨Th17细胞及其分泌的细胞因子IL-17和IL-21在急性白血病发生发展中所起的作用。将60例急性白血病患者(包括急性淋巴细胞性白血病19例和急性髓系白血病41例)分为未缓解组(A组,24例)和缓解组(B组,36例),25例健康志愿者作为对照组(C组)。根据是否合并感染又分为合并感染组(32例)和不合并感染组(28例)。运用酶联免疫吸附法(ELISA法)检测各组外周血单个核细胞(PBMNC)经刺激后培养上清液中IL-17和IL-21的表达水平,用流式细胞术分析PBMNC中CD4+IL-17+细胞的比例。结果发现,①A组和B组产生1L-17、IL-21的水平及Th17比例均低于C组(p0.05);②与B组相比,A组IL-17、IL-21的水平及Th17比例均较低,差异具有统计学意义(p0.05);③合并感染的急性白血病患者IL-17及Th17比例均低于不合并感染组。结论:Th17细胞可能通过分泌IL-17和IL-21参与了急性白血病发生及病情发展,其表达水平高低部分反映了白血病的疾病状态,并可用于评价白血病患者感染发生的风险。

Expression and Clinical Significance of IL-17 and IL-21 in Patients with Acute Leukemia

This study was aimed to investigate the effects of peripheral blood Th17 cells,IL-17 and IL-21 in the occurrence and development of acute leukemia.60 patients with acute leukemia（19 patients with ALL,41 patients with AML） were divided into non-remission group（group A,n=24）,remission group（group B,n=36）;25 healthy volunteers were used as control group（group C）.In addition to this,these 60 patients were divided into infection group（n=32） and non-infection group（n=28） on the basis of infection status.The concentration of IL-17 and IL-21 in the peripheral blood mononuclear cell culture supernatant after stimulation with anti-CD3 and anti-CD28 mAb were determined with ELISA.The expression of CD4＋ IL-17＋ cells was determined by flow cytometry.The results showed that（1） the concentrations of IL-17 and IL-21,and proportion of Th17 cells in group A and group B were much lower than those in group C（p0.05）;（2） the expression levels of IL-17 and IL-21,and the proportion of Th17 cells in group A were lower than those in group B（p0.05）;（3） the expression levels of Th17 and IL-17 in infection group were lower than those in non-infection group（p0.05）.It is concluded that Th17 cells may play important roles in the occurrence and development of acute leukemia through secreting IL-17 and IL-21,and their functional level can partially reflect the status of leukemia and can be used to evaluate the risks of infection in patients with leukemia.