多发性骨髓瘤患者M-MDSC和Th1/Th2细胞因子水平临床意义研究  

Reserch of clinical significance of M-MDSC and Th1/Th2 cytokines in patients with multiple myeloma

作　　者：董书云 江瑞 谢秋娟 DONG Shuyun;JIANG Rui;XIE Qiujuan(Department of Hematology,No.901 Hospital of Joint Logistics Support Forces,Hefei 230032,China;Quality Management Section,No.901 Hospital of Joint Logistics Support Forces,Hefei 230032,China)

机构地区：[1]联勤保障部队第901医院血液内科,合肥230032 [2]联勤保障部队第901医院质量管理科,合肥230032

出　　处：《国际免疫学杂志》2024年第6期583-587,共5页International Journal of Immunology

基　　金：国家自然科学基金(82200225)。

摘　　要：目的研究多发性骨髓瘤(multiple myeloma,MM)患者外周血中髓系来源抑制性细胞(myeloid-derived suppressor cell,MDSC)和辅助性T细胞(helper T Cell,Th)1/Th2细胞因子的表达水平及临床意义。方法收集2021年1月至2023年12月于联勤保障部队第901医院血液内科初次诊断的58例MM患者设为实验组,另选取同期30例健康志愿者为对照组,流式细胞术检测两组实验对象单核细胞型MDSC(M-MDSC)和Th1/Th2细胞因子的表达水平并分析其与临床特征和疗效的相关性。结果与对照组相比,MM组患者外周血中M-MDSC的表达水平明显升高,差异具有统计学意义[(25.21±9.71)%比(9.41±3.23)%,t=8.63,P<0.05];Ⅲ期MM患者M-MDSC水平高于Ⅰ~Ⅱ期患者,差异具有统计学意义[(29.94±10.43)%比(18.58±9.11)%,t=6.41,P<0.05];与肾功能正常患者相比,伴肾功能异常的MM患者M-MDSC水平亦升高,差异具有统计学意义[(27.33±11.68)%比(21.16±8.63)%,t=4.81,P<0.05];与对照组相比,MM患者干扰素(interferon,IFN)-γ表达水平降低,而白细胞介素(interleukin,IL)-4、IL-6和IL-10表达水平明显升高,差异具有统计学意义[(0.55±0.21)pg/mL比(1.21±0.31)pg/mL;(1.41±0.38)pg/mL比(0.55±0.16)pg/mL;(89.61±23.22)pg/mL比(1.21±0.18)pg/mL;(36.16±11.82)pg/mL比(1.30±0.23)pg/mL,t值分别为4.63、5.67、18.62、15.68,P值均<0.05]。两组研究对象IL-2和肿瘤坏死因子(tumor necrosis factor,TNF)-α表达水平差异无统计学意义(P>0.05)。相关分析表明,M-MDSC与IL-6和IL-10呈正相关(r值分别为0.65和0.58,P值均<0.05),与IFN-γ和IL-4未见相关性(P值均>0.05)。治疗后,M-MDSC、IL-4、IL-6和IL-10表达水平明显下降,IFN-γ表达水平明显升高,差异均具有统计学意义[(26.05±9.87)%比(12.25±4.63)%;(1.56±0.32)pg/mL比(0.87±0.26)pg/mL;(85.62±21.83)pg/mL比(11.56±6.12)pg/mL;(33.12±10.35)pg/mL比(8.31±3.29)pg/mL;(0.59±0.23)pg/mL比(1.15±0.41)pg/mL,t值分别为7.65、4.68、14.36、9.68、4.96,P值均<0.05]。结论MM患者M-MDSC和Th1/Th2�Objective To study the levels and clinical significance of myeloid-derived suppressor cells(MDSC)and Th1/Th2 cytokines in the peripheral blood of patients with multiple myeloma(MM).Methods Total of 58 MM patients initially diagnosed in the Department of Hematology,No.901 Hospital of the Joint Logistics Support Force from January 2021 to December 2023 were selected as the experimental group,and 30 healthy volunteers were selected as the control group during the same period.The expression levels of monocytic MDSC(M-MDSC)and Th1/Th2 cytokines in the groups were detected by flow cytometry,and the correlation with clinical characteristics and therapeutic effect was analyzed.Results The level of M-MDSC was significantly higher in MM patients than that of the control group[(25.21±9.71)%vs(9.41±3.23)%,t=8.63,P<0.05];the level of M-MDSC in stageⅢpatients was significantly higher than that in stage I~II patients[(29.94±10.43)%vs(18.58±9.11)%,t=6.41,P<0.05].Accompanied by abnormal renal function,the M-MDSC level was also significantly higher compared with patients with normal renal function[(27.33±11.68)%vs(21.16±8.63)%,t=4.81,P<0.05].The level of interferon(IFN)-γwas significantly lower than that of the control group,and the levels of interleukin(IL)-4,IL-6 and IL-10 were significantly higher than those of the control group[(0.55±0.21)pg/mL vs(1.21±0.31)pg/mL;(1.41±0.38)pg/mL vs(0.55±0.16)pg/mL;(89.61±23.22)pg/mL vs(1.21±0.18)pg/mL;(36.16±11.82)pg/mL vs(1.30±0.23)pg/mL,t values were 4.63,5.67,18.62,15.68 respectively,all P values<0.05].There was no significant difference in the expression levels of IL-2 and tumor necrosis factor(TNF)-αbetween the two groups(P>0.05).M-MDSC was positively correlated with IL-6 and IL-10(r values were 0.65 and 0.58,both P values<0.05)and had no obvious correlation with IFN-γand IL-4(P>0.05).After treatment,the levels of M-MDSC,IL-4,IL-6 and IL-10 decreased significantly and the level of IFN-γincreased significantly[(26.05±9.87)%vs(12.25±4.63)%;(1.56±0.32)pg/mL vs(0.87±0

关 键 词：多发性骨髓瘤 髓系来源抑制性细胞 TH1/TH2 免疫逃逸 

分 类 号：R733.1[医药卫生—肿瘤]