多发性骨髓瘤患者外周血25-羟基维生素D3水平与T细胞亚群的相关性  被引量:2

Correlation of peripheral blood 25-hydroxyvitamin D3 level with T cell subsets in multiple myeloma

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作  者:谷梨花 付彬[2] 王波[2] 关建民 Gu Lihua;Fu Bin;Wang Bo;Guan Jianmin(Department of Hematology,Jining NO.1 People's Hospital,Jining 272000,China;Department of Hematology,Heze Municipal Hospital,Heze 274000,China)

机构地区:[1]济宁市第一人民医院血液科,济宁272000 [2]菏泽市立医院血液科,菏泽274000

出  处:《白血病.淋巴瘤》2023年第11期647-651,共5页Journal of Leukemia & Lymphoma

基  金:山东省医药卫生科技发展计划(2018WS504)。

摘  要:目的探讨多发性骨髓瘤(MM)患者外周血25-羟基维生素D3[25-(OH)D3]水平与T细胞亚群的相关性。方法回顾性分析2019年6月至2021年6月在菏泽市立医院、济宁市第一人民医院住院治疗的11例初诊MM患者临床资料,选择8名健康体检者为健康对照组。患者经BD(硼替佐米+地塞米松)方案治疗4个疗程后疾病缓解。采用高效液相色谱-串联质谱(HPLC-MS/MS)法测定MM患者初诊时、治疗4个疗程后及健康对照组外周血25-(OH)D3水平,采用流式细胞术测定外周血辅助T细胞(Th)1、Th2、Th17、调节性T细胞(Treg细胞)在CD3+CD8+T细胞中所占的比例,采用全自动生化分析仪分析IgA、IgG、IgM、乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)水平,采用细胞分析仪检测外周血血红蛋白水平。比较MM患者初诊时、治疗缓解后各指标与健康对照组间的差异,采用Pearson法分析MM患者初诊时、治疗缓解后外周血25-(OH)D3水平与T细胞亚群、其他生化指标的相关性。结果与健康对照组相比,MM患者初诊时外周血25-(OH)D3水平、Th1与Th2比值(Th1/Th2)、Treg细胞比例均降低(均P<0.01),Th17与Treg细胞比值(Th17/Treg)升高(P=0.002);MM患者治疗缓解后Th17比例、Th17/Treg高于健康对照组(均P<0.05),Treg细胞比例低于健康对照组(P=0.010),25-(OH)D3水平虽低于健康对照组,但差异无统计学意义(P=0.060)。MM患者初诊时和治疗缓解后外周血IgM均低于健康对照组(均P<0.01),LDH、β2-MG水平均高于健康对照组(均P<0.05)。MM患者初诊时外周血25-(OH)D3水平与Th1比例、Th1/Th2均呈正相关(r值分别为0.89、0.60、均P<0.05),与Th17比例、Th17/Treg均呈负相关(r值分别为-0.61、-0.75,均P<0.05);治疗缓解后外周血25-(OH)D3水平与Th1比例、Th2比例、Th1/Th2、Th17比例、Treg细胞比例、Th17/Treg均无相关性(r值分别为-0.36、-0.45、-0.10、0.10、0.19、0.03,均P>0.05)。MM患者初诊时外周血25-(OH)D3水平与IgM、LDH、β2-MG均呈负相关(rObjective To investigate the correlation of peripheral blood 25-hydroxyvitamin D3[25(OH)D3]level with T cell subsets in multiple myeloma(MM).Methods The clinical data of 11 newly diagnosed MM patients hospitalized in Heze Municipal Hospital and the First People's Hospital of Jining from June 2019 to June 2021 were retrospectively analyzed,and 8 healthy people were selected as the healthy control group.The patients achieved disease remission after 4 courses of BD(bortezomib+dexamethasone)regimen.High performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)was used to measure the peripheral blood 25-(OH)D3 level in MM patients at initial diagnosis and after 4 courses of treatment,as well as people in the healthy control group.The proportion of peripheral blood helper T cell(Th)1,Th2,Th17,and regulatory T cells(Treg cells)in CD3+CD8+T cells was measured by using flow cytometry.IgA,IgG,IgM,lactic dehydrogenase(LDH),β2-microglobulin(β2-MG)levels were analyzed by using fully automatic biochemical analyser.Cytoanalyze was used to detect the hemoglobin level in the peripheral blood.The differences of all indicators in MM patients at initial diagnosis,remission after treatment and the healthy control group were compared.Pearson method was used to analyze the correlation of the peripheral blood 25-(OH)D3 level with T cell subsets and other biochemical indicators in MM patients at initial diagnosis and remission after treatment.Results Compared with the healthy control group,the peripheral blood 25-(OH)D3 level,Th1-to-Th2 ratio(Th1/Th2),the proportion of Treg cells were all decreased(all P<0.01),and Th17-to-Treg cells ratio(Th17/Treg)was increased(P=0.002).The proportion of Th17 and Th17/Treg in MM patients achieving remission after treatment was higher than that in the healthy control group(all P<0.05);the proportion of Treg cells in MM patients achieving remission after treatment was lower than that in the healthy control group(P=0.010);25-(OH)D3 level in MM patients achieving remission after treatment was

关 键 词:多发性骨髓瘤 25-羟基维生素D3 T淋巴细胞亚群 

分 类 号:R733.3[医药卫生—肿瘤]

 

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