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再生障碍性贫血患者外周血Th22细胞水平的变化及意义

Change and significance of Th22 cells in patients with aplastic anemia

摘要:

目的 观察Th22细胞在再生障碍性贫血(AA)患者外周血中的水平变化,并探讨其意义.方法 选择淮安市第二人民医院血液科2011年1月至2012年6月住院的重型初诊AA患者11例,非重型初诊AA患者12例,重型治疗后有效患者12例,非重型治疗后有效患者12例,以12名健康体检者作为对照组.用流式细胞术分别检测各组外周血中Th22细胞所占比例.ELISA法分别检测各组外周血中白细胞介素22(IL-22)、转化生长因子β(TGF-β)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的表达水平.用半定量反转录(RT)-PCR分别检测各组外周血中IL-22 mRNA的表达水平,并逐层分析比较.结果 AA重型初诊组和重型治疗有效组Th22细胞比例、IL-22、TNF-α、IL-6、IL-22 mRNA的表达水平均明显高于健康对照组[4.3%±1.4%和2.6%±0.6%比1.2%±0.3%、(57±17)和(34±10)比(19±6)ng/L、(497±123)和(314±79)比(228±50) ng/L、(322±88)和(187±45)比(134±26)ng/L、1.65±0.51和0.92±0.28比0.47±0.09,均P<0.05];治疗有效组低于初诊组(均P<0.05).在非重型患者中亦有类似结果.重型初诊患者以上各项表达水平均高于非重型初诊患者(均P <0.05),但重型治疗有效组与非重型治疗有效组间差异无统计学意义(均P>0.05).AA重型初诊组和重型治疗有效组TGF-β水平分别为(3.4±1.1)、(5.8±1.7) ng/L,明显低于健康对照组[(9.7 ±2.8)ng/L,P<0.05],且初诊组低于治疗有效组(P<0.05);在非重型患者亦有类似结果;且重型初诊患者低于非重型初诊患者(P<0.05),但重型治疗有效组与非重型治疗有效组间差异无统计学意义(P>0.05).结论 AA患者体内Th22细胞数量增加,可能与AA的发生发展呈正相关,提示AA患者体内TNF-α、IL-6的表达升高及TGF-β的表达减低可能促进Th22细胞的分化发育.

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abstracts:

Objective To explore the proportion of Th22 cells in peripheral blood of patients with aplastic anemia (AA) and evaluate its significance.Methods From January 2011 to June 2012,a total of 47 AA patients were recruited and divided into 4 groups:severe aplastic anemia (SAA) pre-therapy (group A,n =11),non-severe aplastic anemia (NSAA) pre-therapy (group B,n =12),SAA post-therapy (group C,n =12),NSAA post-therapy (group D,n =12) and healthy donor controls (n =12).The proportion of Th22 cells in peripheral blood of each group was evaluated by flow cytometry.The cytokines interleukin-22 (IL-22),transforming growth factor-β (TGF-β),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by ELISA.And the level of IL-22 mRNA was examined by reverse transcription-PCR (RT-PCR).Results The percentage of Th22 cells and the level of IL-22,TNF-α,IL-6 and IL-22 mRNA ingroupA (4.3% ±1.4%,(57 ±17)ng/L,(497±123)ng/L,(323 ±88)ng/L,1.65 ±0.51) and groupC (2.6% ±0.6%,(34 ±10)ng/L,(314 ±79)ng/L,(187 ±45) ng/L,0.92 ±0.28) were significantly higher than that in control group (1.2% ± 0.3 %,(19 ± 6) ng/L,(228 ± 50) ng/L,(134 ± 26) ng/L,0.47 ± 0.09,all P < 0.05).The percentage of Th22 cells and the level of IL-22,TNF-α,IL-6 and IL-22 mRNA in group A were higher than those in group C (all P < 0.05).NSAA patients had similar results.The percentage of Th22 cells and the level of IL-22,TNF-α,IL-6 and IL-22 mRNA in group A were higher than those in group B (all P < 0.05).But the level of TGF-β in groups A and C were significantly lower than that in control group ((3.4 ± 1.1) and (5.8 ± 1.7) vs (9.7 ± 2.8) ng/L,P < 0.05).And the level of TGF-β in group A was lower than that of group B (P < 0.05).Conclusions The number of Th22 cells is elevated in AA patients.Th22 cells may be positively correlated with the development of AA.And a higher level of TNF-α,IL-6 and a lower level of TGF-β promote the differentiation of Th22 cells.

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