多发性骨髓瘤患者T细胞共刺激分子表达和调节性T细胞检测及意义  

Expression of costimulatory molecules on T lymphocytes and Tregs in multiple myeloma

作　　者：贾丽[1] 谢晓宝[1] 邱国强[1] 曹祥山[1] 顾伟英[1] 严峰[1] 凌云[1] 周民[2] 

机构地区：[1]苏州大学附属第三医院血液科,江苏常州213003 [2]常州市第二人民医院血液科

出　　处：《临床内科杂志》2009年第11期756-758,共3页Journal of Clinical Internal Medicine

摘　　要：目的通过检测多发性骨髓瘤患者外周血T细胞共刺激分子CD28表达及CD4^＋CD25^high调节性T细胞（Tregs）水平，探讨其免疫功能状态及临床意义。方法采用流式细胞术检测38例多发性骨髓瘤患者及20例健康志愿者外周血T细胞亚群cD。表达和CD4^＋CD25^high Tregs水平。分别采用透射免疫比浊法、溴甲酚绿法及速率法测定患者血清β2-微球蛋白（β2--MG）、白蛋白（Alb）及乳酸脱氢酶（LDH）水平。结果与正常对照组相比，多发性骨髓瘤患者外周血CD4＋T细胞百分率降低、CD8^＋T细胞百分率升高、CD4／CD8比值降低（P〈0．05或P〈0．01），进一步研究发现CD4^＋和CD8^＋T细胞CD28表达均较对照组明显下降，而CD4^＋CD25^high Tregs百分率显著升高（P〈0．05，P〈0．01）。CD4^＋和CD8^＋T细胞CD28表达在进展期明显低于稳定期（P均〈0．01），而CD4^＋CD25^high Tregs在稳定期和进展期间比较差异无统计学意义（P〉0．05）。多发性骨髓瘤患者CD4^＋T细胞CD28表达、CD8^＋T细胞C28表达均与其血清β2-MG水平呈负相关，而与Alb水平呈正相关（P〈0．05，P〈0．01），CD4^＋CD25^high Tregs与Alb水平呈负相关（P〈0．05）。结论多发性骨髓瘤患者存在T细胞亚群共刺激分子CD28表达缺陷和CD4^＋CD25^high Tregs扩增，并与病情进展及预后存在一定相关性。Objective To evaluate the changes and the clinical significance of the expression of CD2s on T lymphocytes and CD4^＋CD25^high regulatory T cells（Tregs） in patients with multiple myeloma（MM）. Methods Expression of CD28 on T lymphocytes and CD4^＋CD25^high Tregs in peripheral blood of 38 patients with MM and 20 healthy doners were measured by the flow cytometry. Serum β2-MG, albumin and LDH in patients with MM were measured using transmission turbidimetry, bromocresol green method and rate method respectively. Results Compared to controls ,the percentage of circulating CD4^＋T cells in patients with MM was lower,the percentage of CD8^＋ T cells was higher, and CD4/CDs ratio was lower. Furtherfore, the expressions of CD28 on CD4 T cells and on CDs T cells were lower, while the percentage of CD4^＋CD25^high Tregs was higher in MM. The expressions of CD28 on CD4^＋T cells and on CDs T cells were lower in in active MM than those in stable MM ,hower,the percentage of CD4^＋CD25^high Tregs in active MM was not different from stable MM. The expressions of CD28 on CD4^＋ T cells and on CDs T cells had negative correlations with the levels of serum β2-MG and positive correlations with the levels of serum albumin. The percentage of CD4^＋CD25^high Tregs had negative correlation with the levels of serum albumin. Conclusion The patients with MM had a disorder of T lymphocyte subsets expressing low level of CD28 molecules and higher Tregs ,which were associated with disease progression and prognosis of MM to some extent.

关 键 词：多发性骨髓瘤 抗原 CD28 调节性T细胞 

分 类 号：R392.11[医药卫生—免疫学]