急性白血病相关巨噬细胞的性质及rhIFN-γ对其影响的研究  

Study on the properties of acute leukemia-associated macrophages and the effect of rhIFN-γ on it

作　　者：宋建新[1] 欧阳红梅[1] 闻艳[2] 撒亚莲[3] SONG Jianxin;OUYANG Hongmei;WEN Yan;SA Yalian(Department of Clinical Laboratory;Department of Hematology;Institute of Clinical Basic Medicine Research,the First People′s Hospital of Yunnan Province,Kunming,Yunnan 650032,China)

机构地区：[1]云南省第一人民医院检验科,昆明650032 [2]云南省第一人民医院血液科,昆明650032 [3]云南省第一人民医院临床基础研究所,昆明650032

出　　处：《重庆医学》2019年第19期3292-3296,3302,共6页Chongqing medicine

基　　金：云南省科技厅-昆明医科大学联合专项应用基础研究项目(2014FZ070)

摘　　要：目的探讨急性白血病(AL)患者骨髓中巨噬细胞的性质及重组人γ-干扰素(rhIFN-γ)对AL荷瘤情况下巨噬细胞的干预作用。方法采用免疫组织化学法检测97例初诊AL患者,包括急性髓系白血病(AML组)71例和急性淋巴细胞白血病(ALL组)26例,以及30例健康者(对照组)骨髓组织中CD68+、CD163+表达情况。97例AL患者中追踪观察53例,其中经治疗后完全缓解(CR)37例、未缓解(NR)或部分缓解(PR)16例,而CR后复发8例。应用不同浓度rhIFN-γ对培养后的AML组单个核细胞进行干预,用流式细胞仪检测CD68+、CD163+的变化及白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平。结果AML组和ALL组骨髓组织中CD68+、CD163+水平高于对照组(P<0.05),而AML组和ALL组组间比较差异无统计学意义(P>0.05)。CR患者CD68+、CD163+水平低于AL患者但高于对照组(P<0.05),但NR/PR及复发患者CD68+、CD163+水平与AL患者分别比较,差异无统计学意义(P>0.05)。治疗前CR患者CD68+、CD163+水平低于治疗前NR/PR患者(P<0.05)。AML组骨髓单个核细胞经不同浓度rhIFN-γ干预7 d后,CD68+水平随着干预浓度的增高而逐渐升高,但在各干预浓度间比较,差异无统计学意义(P>0.05);CD163+水平随着干预浓度的增高而逐渐降低,当干预浓度大于或等于2×10 5 U/L时,其与对照组比较,差异有统计学意义(P<0.05);而当干预浓度为1×10 6 U/L时,CD163+与CD68+水平比较,差异有统计学意义(P<0.05)。IL-10水平随着干预浓度的增高而降低,TNF-α水平则随着干预浓度的增高而升高。当干预浓度为1×10 6 U/L时,IL-10和TNF-α水平与对照组分别比较,差异有统计学意义(P<0.05)。结论AL患者骨髓中M2型巨噬细胞的异常表达,可能与AL的发生、疗效、预后相关;在AL荷瘤情况下,一定浓度的rhIFN-γ具有将M2型向M1型巨噬细胞“逆转”的功能。Objective To investigate the properties of macrophages in the bone marrow of patients with acute leukemia(AL)and the effect of recombinant humanγ-interferon(rhIFN-γ)on macrophages in tumor-bearing leukemia patients.Method Immunohistochemistry was used to detect CD68+and CD163+in bone marrow of 97 newly diagnosed AL patients,including 71 patients with acute myeloid leukemia(the AML group)and 26 patients with acute lymphoblastic leukemia(the ALL group),and 30 normal people(the control group).A total of 53 cases were followed up among the 97 AL patients,including 37 cases with complete remission(CR)after treatment,16 cases with non-remission(NR)or partial remission(PR),while 8 cases with recurrence after CR.The cultured mononuclear cells in the AML group were treated with different concentrations of rhIFN-γ,the changes of CD68+and CD163+,the levels of interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were detected by flow cytometry.Results The levels of CD68+and CD163+in the AML group and the ALL group were higher than those in the control group(P<0.05),but there was no significant difference between the AML group and the ALL group(P>0.05).The levels of CD68+and CD163+in CR patients were lower than those in AL patients(P<0.05),while there were no significant differences among NR/PR,recurrence patients and AL patients(P>0.05).The levels of CD68+and CD163+in CR patients before treatment were lower than those in NR/PR patients before treatment(P<0.05).After 7 days of intervention with different concentrations of rhIFN-γin the AML group,the level of CD68+increased gradually with the intervention concentration increasing,but there was no significant among the different intervention concentrations(P>0.05).The level of CD163+decreased gradually with the intervention concentration increasing.Compared with the control group,when the intervention concentration was more than or equal to 2×10 5 U/L,the difference in the level of CD163+was statistically significant(P<0.05).When the concentration was 1×10 6 U/L,the d

关 键 词：急性白血病 巨噬细胞 CD68 CD163 

分 类 号：R55[医药卫生—血液循环系统疾病]