慢性淋巴细胞白血病患者外周血Th17和Treg细胞比率的平衡关系研究

摘要

This study was purposed to investigate the ratio of Th17 cells and CD4+ CD25+ Foxp3+ regulatory T (Treg) cells in peripheral blood of patients with chronic lymphocytic leukemia(CLL) and to explore their roles in the pathogenesis and clinical diagnosis. Based on the number of peripheral lymphocytes and treatment condition, the CLL patients were divided into 2 groups:untreated group (n = 30) and remission group (n= 15) , the healthy control group (n = 20) was set up as well. The frequencies of Thl7 and Treg cells of all cases were detected by flow cytometry (FCM). The results showed that frequencies of CD3+ CD4+ T cells and Thl7 cells were significantly higher in untreated group than that in healthy control group (P < 0. 05), the frequencies of CD3+ CD8+ T cells and Treg cells were significantly lower in untreated group than that in healthy control group (P < 0.05), the ratio of Thl7/Treg was significantly higher in untreated group than that in healthy control group (P <0.05). The frequencies of Th17 were not statistically different between remission and healthy control groups, the frequencies of Treg cells were significantly lower in remission group than that in healthy control group (P < 0. 05), the ratio of Th17/Treg was significantly higher in remission group than that in healthy control group ( P < 0. 05 ), frequencies of Th17 cells were markedly lower in remission group than that in untreated group (P < 0. 05). It is concluded that Thl7/Treg imbalance exists in patients with CLL, which may play a key role in pathogenesis and development of CLL.%本研究通过检测慢性淋巴细胞白血病(CLL)患者外周血中Th17和CD4+ CD25+ Foxp3+调节性T(Treg)细胞的比率及其平衡关系,探讨其在CLL发病机制中的作用及临床意义.CLL患者根据外周血淋巴细胞计数及治疗情况,分为初发组30例和治疗后缓解组15例,另设健康对照20例.用流式细胞术(FCM)检测CLL患者和健康对照者外周血中T细胞亚群及Th17和CD4+ CD25+ Foxp3+ Treg细胞占CD4+T细胞的比率.结果显示,初发组CLL患者外周血CD3+ CD4+T细胞和Th17细胞的比率均明显高于健康对照组(P＜0.05),CD3+ CD8+T细胞和CD4+ CD25+ Foxp3+ Treg细胞表达率明显低于健康对照组(P＜0.05),Th 17/Treg细胞比值明显高于健康对照组(P＜0.05)；缓解组CLL患者Th17细胞比率与健康对照组相当,而CD4+ CD25+ Foxp3+ Treg细胞表达率明显低于健康对照组(P＜0.05),Th17/Treg细胞比值明显高于健康对照组(P＜0.05)；缓解组CLL患者Th17细胞比率显著低于初发组(P＜0.05).结论:CLL患者外周血T细胞紊乱以CD4+T细胞的增加为主,Th17细胞比率增加和CD4+ CD25+ Foxp3+ Treg细胞比率降低导致Th17/Treg细胞比率失衡,该免疫失衡在CLL的发生发展中可能起重要作用.