多发性骨髓瘤患者外周血CD4^+ CD25^+和CD8^+ CD28^-调节性T细胞研究  

Circulating CD4^+ CD25^+ and CD8^+ CD28^- T regulate cells in multiple myeloma

作　　者：贾丽[1] 谢晓宝[1] 邱国强[1] 钱新瑜[1] 周民[2] 肖溶[2] 

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

出　　处：《中国免疫学杂志》2009年第11期1033-1037,共5页Chinese Journal of Immunology

摘　　要：目的:探讨CD4+CD25+和CD8+CD28-调节性T细胞(Tregs)在多发性骨髓瘤(MM)患者外周血中的变化及意义。方法:采用流式细胞术检测38例MM患者及20例健康对照外周血CD4+CD25+和CD8+CD28-Tregs水平。分别采用溴甲酚绿法、透射免疫比浊法测定患者血清白蛋白(Alb)、β2-微球蛋白(β2-MG)。结果:初诊MM患者外周血CD4+CD25+/high、CD4+CD25highCD127low及CD8+CD28-Tregs比率均明显升高;CD4+CD25+/high和CD4+CD25highCD127lowTregs比率在各临床分期均较对照组升高,随分期增高呈现增加趋势,且CD4+CD25high和CD4+CD25highCD127lowTregs在Ⅲ期患者显著高于Ⅰ期患者;CD8+CD28-Tregs在Ⅱ、Ⅲ期显著高于正常对照,且Ⅱ期高于Ⅰ期,Ⅲ期高于Ⅱ期,逐期递增,而在Ⅰ期与对照组比较无显著差异;CD4+CD25+/high和CD4+CD25highCD127lowTregs比率在进展期和稳定期均较对照组升高,但两期之间比较无明显差异,而CD8+CD28-Tregs在进展期高于稳定期及对照组,稳定期和对照组间比较无明显差异;CD4+CD25highTregs和CD4+CD25highCD127lowTregs比率与Alb水平均呈负相关。结论:MM患者体内存在CD4+CD25+Tregs和CD8+CD28-Tregs异常增加,可能是MM免疫逃逸的一个重要机制,这些变化同临床分期、病情进展及预后存在一定程度相关性。Objective： The study was designed to evaluate the changes and significance of circulating CD4 ＋ CD25＋ and CD8＋ CD28 - regulatory T ceils （Tregs） in patients with muhiple myeloma （MM）. Methods： CD4＋ CD25 ＋ and CD8 ＋ CD28- Tregs in peripheral blood of 38 patients with MM and of 20 healthy doners were measured by flow cytometry. Serum albumin and β2-MG in patients with MM were measured using bromocresol green method, transmission turhidimetry respectively. Results： Compared to those of the controls, the proportions of CD4＋ CD25 ＋/high, CD4 ＋ CD25high CD 127low and CD8 ＋ CD28- Treg cells in newly diagnosed MM patients were elevated. Furthermore, the proportions of CD4 ＋ CD25high and CD4 ＋ CD25highCD127low Tregs in each clinical stage were elevated when compared to those of the controls. The number of the Tregs were increasing with clinical stages and were significantly higher in stage Ⅲ MM than in stage Ⅰ MM ; In stage Ⅱ and Ⅲ MM, there were also elevated proportions of CD8 ＋ CD28- Tregs, increasing with clinical stages. However, there were no differences when compared between stage i MM and the controls; Both the proportions of CD4＋ CD25 ＋/high and CD4 ＋ CD25highCD127low Tregs in active MM were not different from stable MM, although all of them were higher than those of controls. The proportion of CD8 ＋ CD28 - Tregs was higher in active MM than in stable MM and controls, but there were no differences when compared between active and stable MM. The proportions of both CD4 ＋ CD25high Tregs and CD4＋ CD25highCD127lowTregs had negative correlation with the levels of serum albumin. Conclusion： MM patients have elevated levels of circulating CD4＋ CD25 ＋ and CD8＋ CD28 - Tregs, which may be an important mechanism of MM immune evasion, and may be associated with clinical stages, disease progression and prognosis of MM to some extent.

关 键 词：多发性骨髓瘤 CD4+ CD25+调节性T细胞 CD8+ CD28-调节性T细胞 

分 类 号：R392.11[医药卫生—免疫学]