[1]萧杏贤,刘　德,姜朝晖.AML不同疾病阶段患者T细胞耗竭及相关细胞因子表达水平实验研究[J].现代检验医学杂志,2022,37(03):138-143.[doi:10.3969/j.issn.1671-7414.2022.03.029]
　XIAO Xing-xian,LIU De,JIANG Zhao-hui.Experimental Study on T Cell Exhaustion and Related Cytokine Expression Levels in Patients with AML at Different Disease Stages[J].Journal of Modern Laboratory Medicine,2022,37(03):138-143.[doi:10.3969/j.issn.1671-7414.2022.03.029]
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AML不同疾病阶段患者T细胞耗竭及相关细胞因子表达水平实验研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年03期
页码:
138-143
栏目:
研究简报·实验技术
出版日期:
2022-05-15

文章信息/Info

Title:
Experimental Study on T Cell Exhaustion and Related Cytokine Expression Levels in Patients with AML at Different Disease Stages
文章编号:
1671-7414（2022）03-138-06
作者:
萧杏贤; 刘　德; 姜朝晖
（江门市中心医院血液内科，广东江门 529000）
Author(s):
XIAO Xing-xian;  LIU De;  JIANG Zhao-hui
（Department of Hematology, Jiangmen Central Hospital，Guangdong Jiangmen 529000, China）
关键词:
急性髓系白血病; T 细胞耗竭; 细胞因子
分类号:
R557；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.03.029
文献标志码:
A
摘要:
目的　探讨急性髓系白血病（ acute myeloid leukemia， AML）不同疾病阶段患者 T细胞耗竭（ T cell exhaustion, Tex）及相关细胞因子的表达水平。方法　选择 2017年 2月～ 2020年 6月接受治疗的 AML患者 120例，同期选择 60例体检健康者为对照组（ HC组）。根据 AML不同疾病阶段患者可分为初诊（ initial diagnosis, ND）45例、完全缓解（ complete remission, CR）35例、未缓解（ ono-remission, NR）24例和复发（ recurrence, HR）16例，采用流式细胞仪检测各组外周血和骨髓不同免疫检查点 Tex（PD1+TIM-3+T，PD1+T和 TIM-3+T），IL-2和 IFN-γ细胞因子的表达水平。结果　AML不同疾病阶段患者外周血和骨髓中 CD4+PD1+TIM-3+T和 CD8+PD1+TIM-3+T细胞水平均高于 HC组（F=9.149, 6.068, 3.438, 4.807, 均 P＜ 0.001），CR患者外周血和骨髓中 CD4+PD1+TIM-3+T细胞（ t=6.320，8.841， 37.420, 均 P＜ 0.001）和 CD8+PD1+TIM-3+T细胞 (t=5.417，6.096，12.610, 均 P＜ 0.001)水平均明显低于 ND，NR和 HR患者，差异均有统计学意义。 AML患者外周血和骨髓中 CD8+PD1+TIM-3+T细胞数明显高于 CD4+PD1+TIM-3+T细胞数（t=8.227，7.289, 均 P＜ 0.001），且 ND患者骨髓 CD4+PD1+TIM-3+T和 CD8+PD1+TIM-3+T细胞水平明显高于外周血（t=6.297，7.527，均 P＜ 0.001），差异均有统计学意义。 ND患者外周血和骨髓中 CD4+PD1+T和 CD8+PD1+T细胞水平明显高于 HC患者（ F=13.810, 8.029, 7.541. 10.540, 均 P＜ 0.001），CR患者外周血和骨髓中 CD4+PD1+T细胞（ t=4.576， 3.164, 5.625，均 P＜ 0.001）和 CD8+PD1+T细胞（ t=5.293, 3.091, 5.091，均 P＜ 0.001）明显低于 ND和 HR患者，差异均有统计学意义。AML患者外周血和骨髓中 CD4+TIM-3+T和 CD8+TIM-3+T细胞水平明显高于 HC组（F=24.230, 9.101, 16.010, 12.540, 均 P＜ 0.001），且 CR患者中 CD4+TIM-3+T和 CD8+TIM-3+T细胞水平明显低于 HR组 (t=3.986，4.621, 均 P＜ 0.001)，差异均有统计学意义； HR患者外周血和骨髓中 PD1+T细胞和 TIM-3+T细胞所产生的 IL-2和 IFN-γ细胞因子明显低于 HC组和 ND患者（ F=6.218，5.925，5.841，5.017, 均 P＜ 0.001）。结论　AML不同疾病阶段患者的外周血和骨髓中 Tex动态变化与其临床特点、缓解复发及预后密切相关。
Abstract:
Objective　To investigate the expression levels of T cell exhaustion (Tex) and related cytokines in patients with acute myeloid leukemia (AML) at different disease states. Methods　120 patients with AML who received treatment from February 2017 to June 2020 were selected, and 60 healthy subjects were selected as control group (HC group) during the same period. AML patients at different disease states were divided into initial diagnosis (ND) 45 cases, complete remission (CR) 35 cases, non-remission(NR) 24 cases, and recurrence (HR) 16 cases, respectively, the expression levels of Tex expression levels (PD1+TIM-3+T, PD1+T and TIM-3+T), IL-2 and IFN-γ cytokines were detected by flow cytometry at different immune checkpoints in each group. Results　CD4+PD1+TIM-3+T and CD8+PD1+TIM-3+T cells levels in peripheral blood and bone marrow of patients with different disease stages of AML were higher than those in HC group （F=9.149, 6.068, 3.438, 4.807, all P ＜ 0.001）. CD4+PD1+TIM-3+T (t=6.320，8.841，37.420, all P ＜ 0.001) and CD8+PD1+ TIM-3+T (t=5.417，6.096，12.610, all P ＜ 0.001) cells levels in peripheral blood and bone marrow of patients with CR were significantly lower than those of patients with ND, NR and HR, the differences were statistically significant, respectively. CD4+PD1+TIM-3+T cells in peripheral blood and bone marrow were significantly higher than CD4+PD1+ TIM-3+T cells（t=8.227，7.289, all P ＜ 0.001）, and CD4+PD1+TIM-3+T and CD8+PD1+TIM-3+T cells levels in bone marrow of newly diagnosed AML patients were significantly higher than those in peripheral blood（t=6.297, 7.527, all P ＜ 0.001）, the differences were statistically significant, respectively. CD4+PD1+T and CD8+PD1+T cells in peripheral blood and bone marrow of ND patients were significantly higher than those in HC patients （F=13.810, 8.029, 7.541, 10.540, all P ＜ 0.001）, CD4+PD1+T cells in peripheral blood and bone marrow of patients with CR (t=4.576, 3.164, 5.625, all P ＜ 0.001) and CD8+PD1+T cells (t=5.293, 3.091, 5.091, all P ＜ 0.001) were significantly lower than those in ND and HR group, the differences were statistically significant, respectively. The levels of CD4+TIM-3+T and CD8+TIM-3+T cells in peripheral blood and bone marrow of AML patients were significantly higher than those of HC patients (F=24.230, 9.101, 16.010, 12.540, all P ＜ 0.001), and CD4+TIM-3+T and CD8+TIM-3+T cells in CR patients were significantly lower than those in HR group (t=3.986, 4.621, all P ＜ 0.001), the differences were statistically significant, respectively. The IL-2 and IFN-γ cytokines secretion of PD1+T and TIM-3+T cells levels in peripheral blood and bone marrow of HR patients were significantly lower than those of HC group and ND patients （F=6.218, 5.925, 5.841，5.017, all P ＜ 0.001）. Conclusion　Tex dynamic changes in peripheral blood and bone marrow at different disease states were closely related to clinical characteristics, remission of recurrence and prognosis of AML patients.

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备注/Memo

备注/Memo:
基金项目：2018 年度江门市科技计划项目（编号：2018A025）。
作者简介：萧杏贤（1981-），女，硕士，副主任医师，主要从事血液病免疫治疗相关研究，E-mail：baiyun133121@163.com。
更新日期/Last Update: 1900-01-01