儿童急性白血病Th1和Th2细胞因子的临床研究

摘要

Objective To investigate the expression of Thl and Th2 cytokines in peripheral blood of children with acute leukemia, and explore its roles in the onset and chemotherapy of leukemia. Methods Seventy-eight children with acute leukemia were enrolled, including 53 cases of acute lymphoblastic leukemia ( ALL) and 25 cases of acute nonlymphocytic leukemia ( ANLL) . Twenty-one cases were newly diagnosed ( newly diagnosed group). All cases were divided into complete remission group 1 (n = 42, duration of complete remission < 12 months) and complete remission group 2 ( n = 36, duration of complete remission ^12 months) after chemotherapy. Another 30 healthy children were served as normal controls. The percentages of Thl (IL-2 and IFN7) and Th2 (IL-4) cytokines in peripheral blood were detected by flow cytometry. Results The levels of IL-2, IFN7 and IL-4 in newly diagnosed group were significantly different from those in normal control group and complete remission groups before treatment (P <0. 05). The levels of IL-2, IFN7 and IL-4 in newly diagnosed group significantly improved after treatment, which were not significantly different from those in normal control group (P > 0. 05). The levels of IL-2 and IFN-y in complete remission group 1 were significantly higher than those in complete remission group 2 (P < 0.05), while there was no significant difference in levels of IL-4 between these two groups (P >0.05), and the levels of IL-2, IFN7 and IL-4 in these two groups were not significantly different from those in normal control group (P>0.05). There was no significant difference in the levels of IL-2, IFN-y and IL-4 between patients with ALL and ANLL (P >0.05). Conclusion Thl and Th2 cytokines may play a role in the process of acute leukemia, and they may produce a similar effect in ALL and ANLL. Along with the prolongation of duration of complete remission, the immunologic function gradually recovers, but it is disturbed again latter, which may be related to immunosuppression secondary to chemotherapy.%目的 研究急性白血病患儿外周血中Th1和Th2细胞因子的表达及其在白血病发病及化疗过程中的意义.方法 收集78例急性白血病患儿,其中急性淋巴细胞白血病(ALL) 53例,急性非淋巴细胞白血病(ANLL) 25例；21例为初诊患者(初诊组).所有患儿经化疗后分为两组:缓解组1(n =42),完全缓解期(CR) ＜12个月；缓解组2(n =36),CR≥12个月.另设30名健康儿童为正常对照组.采用流式细胞术测定外周血Th1( IL-2、IFNγ)和Th2( IL-4)细胞因子的百分比.结果 初诊组治疗前的IL-2、IFNγ和IL-4表达水平与正常对照组和缓解组比较,差异均有统计学意义(P＜0.05)；治疗后表达水平显著改善,与正常对照组比较差异无统计学意义(P＞0.05).缓解组1的IL-2和IFNγ表达水平均显著高于缓解组2(P ＜0.05),但IL-4表达水平差异无统计学意义(P＞0.05)；两组患儿的3种细胞因子表达水平与正常对照组比较差异均无统计学意义(P＞0.05).ALL与ANLL患儿的3种细胞因子表达水平比较,差异均无统计学意义(P＞0.05).结论 Th1和Th2细胞因子可能参与了急性白血病的发病,在ALL与ANLL发病过程中的作用可能相同；随着缓解时间延长,患者的免疫功能逐渐恢复,后期再次紊乱,可能与化疗继发的免疫抑制有关.