肝癌患者自体细胞因子诱导杀伤细胞治疗后免疫活性细胞的检测及其临床意义  

Identification of immunological effector cells after autologous cytokine-induced killer cells treatment and its clinical implication in hepatocellular carcinoma patients

作　　者：施明[1] 张冰[1] 汤紫荣[1] 雷周云[1] 王慧芬[1] 冯永毅 刘敬超[1] 范振平[1] 李捍卫[1] 牟劲松[1] 王福生[1] 

机构地区：[1]解放军第三○二医院全军艾滋病与病毒性肝炎防治重点实验室,北京100039

出　　处：《中华医学杂志》2003年第23期2049-2053,共5页National Medical Journal of China

摘　　要：目的　观察肝癌患者自体细胞因子诱导杀伤细胞 (CIK细胞 )回输后 ,外周血中T细胞亚群及树突状细胞亚群的变化 ,评价CIK细胞治疗肝癌的临床效果。方法　采用成份血采血机采集13例肝癌患者的外周血单个核细胞 (PBMC) ,经多种细胞因子诱导后 ,于培养的第 4、7、10、13、15天流式细胞仪检测细胞表型 ;CIK细胞回输前及回输后取病人外周血 ,流式细胞仪测定Ⅰ型树突状细胞(DC1)和Ⅱ型树突状细胞 (CD2 )的比例。结果　诱导培养后 ,CD3+ CD8+ ,CD3+ CD5 6 + ,CD2 5 + 效应细胞的比例明显升高 ,分别由最初的 33 5 %± 10 1%、7 7%± 2 8%和 12 3%± 4 5 % ,上升至 36 6 %±9 0 %、18 9%± 6 9%和 16 4 %± 5 9% ,其中CD3+ CD8+ 可维持较高水平 ,CD2 5 + 和CD3+ CD5 6 + 比例分别于培养后的第 7天和第 13天开始下降。CD3+ CD4 + 和NK细胞比例略有下降 ,但差异无显著意义。CIK细胞回输后DC1和CD2细胞亚群的比例明显升高 ,分别由回输前的 0 5 9%± 0 2 3%和0 2 6 %± 0 12 %上升至回输后的 0 85 %± 0 2 7%和 0 4 3%± 0 2 0 %。CIK细胞治疗后患者临床症状明显改善 ,无明显副作用。结论　CIK细胞治疗可以提高肝癌患者的细胞免疫功能 ,提高对肿瘤细胞的杀伤作用。Objective To investigate the alteration of the cellular profiles of T lymphocyte subsets and dendritic cell subsets in peripheral blood of primary hepatocellular carcinoma (HCC) patients after being transfused with autologous cytokine-induced killer cells (CIK) in patients, then to evaluate the clinical efficacy of the immune therapeutic strategy.Methods Peripheral blood mononuclear cells (PBMCs) from 13 patients with primary were collected using blood cell separator, and expanded in the fresh AIM-V medium in the presence of cytokine cocktail including interferon-gamma (IFN-γ), monoclonal antibody (mAb) against CD3 and interleukin-2 (IL-2).The phenotypic patterns of CIK cells were longitudinally characterized by flow cytometry on day 0, 4, 7, 10,13 and 15 during the incubation period.PBMCs obtained from HCC patients before or after CIK cells transfusion into bodies to assay the changes of proportion of DC1 or DC2 in peripheral blood.Results After in vitro incubation for 14 or 15 days, a large of CD3 +CD56 + cells were produced from their progenitors and the percentages of CD3 +CD8 +, CD3 +CD56 +,CD25 + cells significantly increased from 33.5%±10.1% , 7.7%±2.8%, and 12.3%±4.5% at the beginning to 36.6%±9.0% (P<0.05), 18.9%±6.9% (P<0.01), and 16.4%±5.9% (P<0.05) at the day 15, respectively.In contrast, the percentages of CD3 +CD4 + and NK cells displayed no significant difference.The percentages of CD3 +, CD3 +CD8 + cells was held at a higher level during the whole incubation period, however those of the CD25 +, and CD3 +CD56 + cells began decreasing on day 7 and day 13, respectively.The proportion of type Ⅰof dendritic cells (DC1) and type Ⅱ of dendritic cells (DC2) subsets increased from 0.59%±0.23% and 0.26%±0.12% before CIK cell transfusion to 0.85%±0.27% and 0.43%±0.20% (all P<0.01) after CIK cell transfusion.The symptom of HCC patients receiving the CIK cell therapy was markedly ameliorated, and not side effect was seen in the treatment.Conclusion Our results indicated tha

关 键 词：肝癌 自体细胞因子 杀伤细胞 免疫活性细胞 临床意义 T细胞亚群 树突状细胞 免疫疗法 

分 类 号：R735.7[医药卫生—肿瘤] R730.51[医药卫生—临床医学]