泊马度胺对复发难治多发性骨髓瘤患者外周血调节性T细胞与辅助T细胞17及炎症因子水平的影响  

The Effect of Pomalidomide on Peripheral Blood Treg and Th17 Cells and Inflammatory Factors Levels in Recurrent/Refractory Multiple Myeloma Patients

作　　者：王炳晨 李美玲 毕耜磊 王英营 关建民 WANG Bing-Chen;LI Mei-Ling;BI Si-Lei;WANG Ying-Ying;GUAN Jian-Min(Department of Hematology,Heze Municipal Hospital,Heze 274000,China;Department of Hematology,Shandong Hospital of Traditional Chinese Medicine,Jinan 250000,China)

机构地区：[1]菏泽医学专科学校临床医学系,山东菏泽274000 [2]菏泽市立医院血液科,山东菏泽274000 [3]山东省中医院血液科,济南250000

出　　处：《中国药物经济学》2024年第11期75-79,87,共6页China Journal of Pharmaceutical Economics

基　　金：山东省医药卫生科技发展计划项目(202203040789)。

摘　　要：目的探讨泊马度胺对复发难治多发性骨髓瘤(RRMM)患者外周血调节性T细胞(Treg)、辅助T细胞17(Thl7)及Th17/Treg比值和白细胞介素-17(IL-17)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)表达水平的影响。方法选取2023年3—10月于菏泽市立医院、山东省中医院行泊马度胺为基础方案治疗的30例RRMM患者为观察组,20例同期健康体检者为对照组。检测两组患者外周血Treg、Th17、Th17/Treg及IL-6、TNF-α、IL-17水平,比较观察组不同疗效患者外周血Treg、Th17、Th17/Treg及IL-6、TNF-α、IL-17水平,分析外周血Treg、Th17、Th17/Treg及血清IL-6、TNF-α、IL-17水平与疗效的相关性。结果观察组治疗前及治疗后外周血Th17、Th17/Treg及血清IL-6、TNF-α、IL-17水平均明显高于健康对照组,Treg水平均明显低于健康对照组,差异有统计学意义(P<0.05);治疗后观察组外周血Th17、Th17/Treg及血清IL-6、TNF-α、IL-17水平均明显低于治疗前,Treg水平明显高于治疗前,差异有统计学意义(P<0.05)。完全缓解组外周血Th17、Th17/Treg及血清IL-6、TNF-α、IL-17水平最低,其次为部分缓解组和轻微缓解组,无效组最高,完全缓解组Treg水平最高,其次为部分缓解组和轻微缓解组,无效组最低。Th17、Th17/Treg及血清IL-6、TNF-α、IL-17水平与治疗效果成正相关关系(P<0.001),Treg与治疗效果成负相关关系(P<0.001)。结论泊马度胺可能通过下调Th17及TNF-α、IL-17、IL-6表达水平,调控Treg及Th17/Treg比例发挥抗骨髓瘤作用,但具体机制有待于进一步研究。Objective To explore the effects of pemalidomide on the expression levels of peripheral blood regulatory T cells(Treg),helper T cells 17(Thl7),Th17/Treg ratio,interleukin-17(IL-17),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)in patients with relapsed refractory multiple myeloma(RRMM).Methods Thirty patients with RRMM who were treated with pomadomide based regimen in Heze Municipal Hospital and Shandong Provincial Hospital of Traditional Chinese Medicine from March to October 2023 were selected as the observation group and 20 healthy subjects during the same period were selected as the control group.The levels of Treg,Th17,Th17/Treg and IL-6,TNF-αand IL-17 in peripheral blood of patients in the two groups were detected,and the levels of Treg,Th17,Th17/Treg and IL-6,TNF-αand IL-17 in peripheral blood of patients with different therapeutic effects in the observation group were compared.The correlation of peripheral blood Treg,Th17,Th17/Treg and serum IL-6,TNF-αand IL-17 levels with therapeutic effect was analyzed.Results The levels of Th17,Th17/Treg in peripheral blood and serum IL-6,TNF-αand IL-17 in the observation group were significantly higher than those in the healthy control group before and after treatment,and the Treg cell level was significantly lower than that in the healthy control group,with statistical significance(P<0.05).After treatment,the levels of Th17,Th17/Treg in peripheral blood and IL-6,TNF-αand IL-17 in serum in observation group were significantly lower than before treatment,and Treg levels were significantly higher than before treatment,with statistical significance(P<0.05).The levels of Th17,Th17/Treg in peripheral blood and IL-6,TNF-αand IL-17 in serum were the lowest in the complete remission group,followed by the partial remission group and the mild remission group,the highest in the ineffective group,and the highest in the complete remission group,followed by the partial remission group and the mild remission group,and the lowest in the ineffective group.The levels of T

关 键 词：泊马度胺 调节性T细胞 辅助T细胞17 复发难治多发性骨髓瘤 白细胞介素-17 

分 类 号：R738.1[医药卫生—肿瘤] R979.1[医药卫生—临床医学]