多发性骨髓瘤Treg和Th17细胞水平变化及转录因子Foxp3、ROR-γt基因表达与临床意义  

Levels of Treg and Th17cells and the gene expression of transcription factors Foxp3and ROR-γt in mutiple myeloma and their clinical significance

作　　者：王冬[1] 刘素芳[1] 肖湘[1] 龚凡杰[1] 邓明扬[1] 张广森[1] 

机构地区：[1]中南大学湘雅二医院血液科/分子血液病研究室,长沙410011

出　　处：《临床血液学杂志》2013年第5期626-628,共3页Journal of Clinical Hematology

基　　金：卫生部公益性行业科研专项(No:201202017);卫生部临床重点专科建设项目(No:2011-2014)

摘　　要：目的:通过分析多发性骨髓瘤(MM)患者外周血Treg细胞、Th17细胞比例及对应的特异转录因子Foxp3、ROR-γt mRNA的表达水平,探讨其与MM分期及预后的关系。方法:收集43例MM患者(MM组)和20例健康对照者(对照组)外周血标本,分离单个核细胞,应用流式细胞术检测Treg细胞和Th17细胞占CD4+T细胞比例,同时应用QRT-PCR方法检测Foxp3、ROR-γt mRNA的相对表达量,并与MM的临床分期及化疗的影响进行相关分析。结果:①MM组外周血Treg细胞/CD4+T细胞比例、Foxp3mRNA表达均较对照组显著升高(均P<0.05),且Ⅲ期患者增加程度较Ⅰ、Ⅱ期患者更为明显,但差异无统计学意义。化疗后复治MM患者Treg细胞比例较未化疗初治患者显著降低(P<0.05)。②MM组外周血Th17细胞/CD4+T细胞比例较对照组差异无统计学意义,而ROR-γt mRNA表达水平较对照组显著升高(P<0.05)。化疗后复治MM患者ROR-γt mRNA表达水平较未化疗初治患者显著性下降(P<0.05)。结论:MM患者外周血Treg细胞比例及Foxp3mRNA表达水平明显升高,并与疾病分期有关,且化疗后复治MM患者较初治患者低,提示Treg细胞可能参与MM患者肿瘤细胞免疫逃逸及恶性增殖。MM患者外周血单个核细胞ROR-γt mRNA表达明显升高,而化疗可以抑制ROR-γt mRNA表达。Objective：To investigate the relationship between Treg cells,Th17 cells,their corresponding specif- ic transcription factor Foxp3,ROR-yt mRNA levels and multiple myeloma （MM） staging and prognosis. Method： We collected the peripheral blood of 43 patients with MM and 20 healthy controls. Flow cytometry was used to de- tect the ratio of Treg cells/CD4＋ T ceils and Thl7 cells/CD4＋ T cells. Meanwhile,the QRT-PCR was applied to detect the expression of Foxp3 mRNA and ROR-）＇t mRN A. Result：（~）Compared with the healthy control,the ratio of Treg cells and the expression level of Foxp3 mRNA in patients with MM were significantly higher （P〈0.05）, and they increased more obviously in patients of stage M than those in stage I and ]I （but P〉0.05）. The ratio of Treg cells and Foxp3 mRNA level in MM patients after chemotherapy were significantly lower than those in pa- tients who hadn＇t undergone chemotherapy （P〈0.05）. （DCompared with the healthy control,there was no statisti- cal difference in the ratio of Th17 cells in patients with MM,while the expression level of ROR yt mRNA was sig- nificantly higher （P〈0.05）. Moreover, the level of ROR-yt mRNA was significantly decreased in patients after chemotherapy than that in patients who hadn＇t undergone chemotherapy （P〈 0.05）. Conclusion： Treg cells ratio and Foxp3 mRNA level in peripheral blood of MM patients increase significantly,and they are related to the disease staging. Moreover,they decrease in patients after chemotherapy illustrating that Treg cells may participate in the immune escape and proliferation of tumor cells in MM patients. ROR-yt mRNA expression level increases signifi- cantly in peripheral blood of MM patients,while the chemotherapy could inhibit its expression.

关 键 词：多发性骨髓瘤 TREG细胞 TH17细胞 Foxp3 MRNA ROR-γt MRNA 

分 类 号：R733.3[医药卫生—肿瘤]