沙利度胺对多发性骨髓瘤患者外周血Th17与Treg细胞比值及IL-17、IL-35表达水平的影响  

Effects of Thalidomide on the Ratio of Th17 to Treg Cells in Peripheral Blood and Expression of IL-17 and IL-35 in Patients with Multiple Myeloma

作　　者：赵玲俊[1] 高松[2] 李晓 

机构地区：[1]哈励逊国际和平医院肿瘤内科,河北衡水053000 [2]哈励逊国际和平医院药剂科,河北衡水053000 [3]哈励逊国际和平医院血液科,河北衡水053000

出　　处：《中国实验血液学杂志》2018年第1期187-191,共5页Journal of Experimental Hematology

摘　　要：目的:探讨沙利度胺对多发性骨髓瘤(MM)患者外周血辅助T细胞17(Th17)与调节性T细胞(Treg)的比值及白介素-17、-35表达水平的影响,为临床MM患者有效治疗提供参考。方法:选取2014年1月-2016年12月医院收治的82例沙利度胺治疗的多发性骨髓瘤患者(M M组)及同时期体检健康者30例(对照组)。流式细胞术检测外周血T细胞亚群与Treg细胞占CD4^+T细胞比率,ELISA法检测血清IL-17和IL-35表达水平,比较患者治疗前后各项指标差异。结果:与对照组比较,多发性骨髓瘤患者治疗前外周血Th17细胞比率、IL-17水平均显著升高(P<0.05),Treg细胞比率和IL-35水平均显著降低,Th17/Treg细胞比值显著升高(P<0.05),沙利度胺治疗有效的多发性骨髓瘤患者外周血Th17细胞比率和IL-17水平明显低于治疗前,Treg细胞比率和IL-35水平明显高于治疗前,Th17/Treg细胞比值较治疗前显著降低(P<0.05);治疗无效者各指标无显著变化(P>0.05)。结论:Th17/Treg细胞比例失衡和IL-17和IL-35水平异常与多发性骨髓瘤疾病进展相关,沙利度胺发挥抗M M的作用机制可能与调节Th17/Treg细胞比值及IL-17和IL-35表达水平有关。Objective： To explore the effects of thalidomide on the ratio of Th17 to Treg cells in peripheral blood and expression of IL-17 and IL-35 in patients with multiple myeloma（ MM）,so as to provide reference for the clinical treatment of patients with MM. Methods： A total of 82 MMpatients treated with thalidomide from January 2014 to December 2016 were enrolled in MMgroup,30 healthy subjects were selected as control（ control group）. The ratio of T cell subsets and Treg cells accounted for CD4~＋T cell were detected by flowcytometer. The levels of IL-17 and IL-35 in serum were measured by ELISA,and the differences of various indexes were compared between 2 groups. Results：Compared with the control group,the ratio of Th17 cells in peripheral blood and serum levels of IL-17 of MMpatients were significantly increased,the ratio of Treg cells and the level of IL-35 were significantly decreased and the ratio of Th17/Treg cells was significantly increased in the patients with multiple myeloma before treatment（ P〈0. 05）. The ratio of Th17 cells in peripheral blood and serum levels of IL-17 in patients with multiple myeloma after treatment with thalidomide were significantly lower than those before treatment,and the ratio of Treg cells and levels of IL-35 were significantly higher than those before treatment,and the ratio of Th17/Treg cells was higher than that before treatment（ P〈0. 05）. The indexes in ineffective treatment were not significantly changed（ P〈0. 05）. Conclusion： The unbanlace of Th17/Treg cell ratio and abnormality of IL-17,IL-35 levels play an important role in the progression of multiple myeloma. The anti-MMmechanism of thalidomide may relate with the regulation of Th17/Treg cell ratio and expression levels of IL-17 and IL-35.

关 键 词：多发性骨髓瘤 沙利度胺 Th17/Treg细胞比例 白介素-35 

分 类 号：R733.3[医药卫生—肿瘤] R979.1[医药卫生—临床医学]