外周血树突状细胞Tim-3蛋白、CD80、CD86表达与骨髓增生异常综合征预后的相关性  

Correlation between the expression of Tim-3 protein,CD80,CD86 in peripheral blood dendritic cells and the prognosis of myelodysplastic syndrome

作　　者：余娟 严晓琴 邹夏 华芳 Yu Juan;Yan Xiaoqin;Zou Xia;Hua Fang(Department of Hematology, West China Hospital of Sichuan University, Sichuan Province, Chengdu 610044,China)

机构地区：[1]四川大学华西医院血液内科,成都610044 [2]四川省自贡市第一人民医院血液免疫科,643000

出　　处：《疑难病杂志》2021年第8期801-806,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：四川省教育厅科研计划项目(18ZA0212)。

摘　　要：目的分析外周血树突状细胞(DC)T细胞免疫球蛋白黏蛋白分子-3(Tim-3)、CD80、CD86表达与骨髓增生异常综合征(MDS)患者预后的相关性。方法选取2015年11月—2017年11月于四川大学华西医院血液内科就诊的MDS患者104例作为研究对象(观察组),并根据MDS国际预后评分系统(IPSS)将患者分为低危亚组(48例)、中危亚组(31例)和高危亚组(25例);另选取同期于医院体检的健康人50例作为健康对照组。收集受试者的临床资料,取肘静脉血分离外周血单个核细胞(PBMC)并诱导DC,流式细胞术检测CD80、CD86含量;蛋白免疫印迹法检测DC细胞中Tim-3蛋白表达水平;比较健康对照组、观察组及不同IPSS预后亚组间Tim-3蛋白、CD80、CD86水平;Pearson法分析DC细胞中Tim-3蛋白及CD80、CD86与MDS患者骨髓指标相关性;比较不同IPSS预后MDS患者3年累积生存率;Logistic回归分析影响MDS患者预后的危险因素。结果观察组外周血PBMC诱导成熟DC细胞的平均比例高于健康对照组(t/P=18.461/0.000);与健康对照组比较,观察组外周血PBMC诱导成熟DC细胞Tim-3蛋白表达水平及CD80、CD86比例均升高(t/P=19.854/0.000、14.264/0.000、7.366/0.000);低危亚组、中危亚组、高危亚组DC细胞中Tim-3蛋白表达水平及CD80、CD86比例依次升高(F/P=38.819/0.000、31.828/0.000、11.803/0.000);MDS患者DC细胞中Tim-3蛋白分别与环状铁粒幼红细胞占有核红细胞比例、骨髓涂片原始细胞呈正相关(r/P=0.624/0.000、0.486/0.023),与血小板计数(PLT)、红细胞计数(RBC)呈负相关(r/P=-0.458/0.032、-0.536/0.001);CD80与环状铁粒幼红细胞占有核红细胞比例、骨髓涂片原始细胞呈正相关(r/P=0.513/0.002、0.573/0.001)与PLT呈负相关(r/P=-0.526/0.002);CD86与环状铁粒幼红细胞占有核红细胞比例呈正相关(r/P=0.571/0.001);低危亚组、中危亚组、高危亚组MDS患者3年累积生存率依次降低(χ^(2)/P=25.360/0.000);多因素Logistic回归分析显示,Tim-3Objective To analyze the correlation between the expression of peripheral blood dendritic cells(DC)T cell immunoglobulin mucin molecule 3(Tim-3),CD80,CD86 and the prognosis of patients with myelodysplastic syndrome(MDS).Methods A total of 104 MDS patients who attended the Department of Hematology,West China Hospital,Sichuan University from November 2015 to November 2017 were selected as the study object(observation group),and the patients were divided into low-risk subgroups according to the MDS International Prognostic Scoring System(IPSS)(48 cases),middle-risk subgroup(31 cases)and high-risk subgroup(25 cases).In addition,50 healthy people who received physical examination in the hospital during the same period were selected as the healthy control group.The clinical data of the subjects were collected,cubital venous blood was taken to separate peripheral blood mononuclear cells(PBMC)and DCs were induced,and the contents of CD80 and CD86 were detected by flow cytometry.Western blotting was used to detect the expression level of Tim-3 protein in DC cells.Compare the levels of Tim3 protein,CD80,and CD86 among healthy control group,observation group and different IPSS prognostic subgroups.Pearson method was used to analyze the correlation between Tim3 protein,CD80,CD86 in DC cells and bone marrow indexes of MDS patients.Compare the 3-year cumulative survival rate of MDS patients with different IPSS prognosis.Logistic regression analysis of risk factors affecting the prognosis of MDS patients.Results The average proportion of mature DC cells induced by peripheral blood PBMC in the observation group was higher than that in the healthy control group(t/P=18.461/0.000).Compared with the healthy control group,the expression level of Tim-3 protein and the ratio of CD80 and CD86 of mature DC cells induced by peripheral blood PBMC in the observation group increased(t/P=19.854/0.000,14.264/0.000,7.366/0.000).The expression level of Tim3 protein and the ratio of CD80 and CD86 in DC cells of low-risk subgroup,intermediate-risk

关 键 词：骨髓增生异常综合征 树突状细胞 T细胞免疫球蛋白黏蛋白分子-3 CD80 CD86 

分 类 号：R551.3[医药卫生—血液循环系统疾病]