急性白血病儿童外周血CD4^+ CD25^+调节性T细胞和NK细胞的变化及其在白血病免疫中的意义  

Change of CD4^+ CD25^+ Regulatory T cells and NK Cells in Peripheral Blood of Children with Acute Leukemia and Its Possible Significance in Tumor Immunity

作　　者：吴泽霖[1] 胡光玉 陈福雄[1] 卢慧敏[1] 吴梓梁[1] 李华梅[1] 卫凤桂[1] 关镜明[1] 吴丽萍[1] 

机构地区：[1]广州医学院第一附属医院儿科,广东广州510120 [2]深圳市松岗人民医院儿科,广东深圳518105

出　　处：《中国实验血液学杂志》2010年第3期709-713,共5页Journal of Experimental Hematology

基　　金：广东省卫生厅资助项目;编号A2004264

摘　　要：本研究观察急性白血病患儿外周血CD4+ CCD25+调节性T细胞(CD4+ CD25+ Treg)及自然杀伤细胞(nature killer cell,NK)在不同病程阶段的变化,了解白血病患儿的免疫状态,以探讨CD4+ CD25+ Treg细胞及NK细胞在急性白血病肿瘤免疫中的意义。建立流式细胞术检测外周血CD4+ CD25+ Treg细胞和NK细胞的方法;检测急性白血病初诊患儿25例、完全缓解患儿28例及20例正常健康对照者外周血CD4+ CD25+ Treg细胞及NK细胞的数量及比例。结果表明:初诊组、完全缓解组及对照组外周血CD4+ CD25+ CD127+占CD4+ T细胞的比例分别为(9.55±2.41)%,(8.54±2.51)%和(6.25±0.85)%,在初诊患儿组和缓解患儿组高于正常对照组,且在初诊患儿组高于完全缓解组(p(0.05);同时,与正常对照组比较,急性白血病患儿的NK细胞数量减少,完全缓解后患儿组NK细胞数量仍低于正常对照(4.11±3.87%和10.41±7.20%vs14.06±5.95%,p(0.05)。结论:联合应用CD4、CD25及CD127检测Treg细胞简便可行、重复性好、检测结果可靠、准确,CD4+ CD25+ CD127+ T细胞可较好地反映CD4+ CD25+ Treg细胞的比例。急性白血病患儿外周血中Treg细胞数量升高,NK细胞数量降低,表明急性白血病患儿NK细胞免疫功能处于抑制状态。Treg细胞可能在白血病的发生、发展中起一定作用,参与NK细胞的调节可能是Treg细胞在白血病免疫中的一个环节。This study was purposed to investigate the changes of CD4 ^＋CD25 ^＋ regulatory T cells and NK cells in peripheral blood of acute leukemia children at different stages, the function of immune system and the possible roles of the CD4 ^＋ CD25 ^＋ regulatory T cells as well as NK cells in leukemia immunity. The number and proportion of CD4 ^＋ CD25 ^＋ regulatory T cells and NK cells were detected by flow cytometry in the peripheral blood of 53 acute leukemia children , including 25 patients in new diagnosis and 28 patients in continuous complete remission （CCR）, and were compared with that of 20 normal children. The results indicated that the mean proportion of CD4 ^＋CD25 ^＋ CD127 ^＋ in CD4 ^＋ T cells of peripheral blood in newly diagnosed patients, patients with CCR and normal children were （9.55 ± 2. 41 ） %, （ 8.54 ± 2.51 ） % and （6.25 ±0.85 ） % respectively, the mean proportions of CD4 ^＋ CD25^＋ CD127 ^＋ in newly diagnosed patients and patients with CCR were higher than that in normal children, the mean proportion of CD4 ^＋ CD25 ^＋ CD127 ^＋ in newly diagnosed patients were higher than that in patients with CCR （p 〈0.05）. At the same time, the NK cell count in patients with acute leukamia decreased as compared with normal control, while after achieving CCR, the NK cell count in patients were also less than that in normal control （4.11 ± 3.87% and 10.41 ± 7.20% vs 14. 06 ± 5.95%, p 〈0.05）. It is concluded that the application of CD4 ^＋ ,CD25 ^＋ and CD127 ^＋to detect regulatory T cells is a simple, reproductive and accurate method, and the CD4 ^＋ CD25^＋ CD127 ^＋T cells can better reflect the proportion of CD4 ^＋ CD25 ^＋ regulatory T cells. The increase of regulatory T cells and decrease of NK cells in pediatric patients with acute leukemia indicate that the function of NK cells may be depressed. Treg T cells play a role in occurrence and development of leukemia, and are involved in down-regulating NK cell function.

关 键 词：急性白血病 外周血 CD4^+CD25^+CD127^+Treg细胞 NK细胞 肿瘤免疫 

分 类 号：R733.71[医药卫生—肿瘤] R730.51[医药卫生—临床医学]