调节性T细胞及Th1/Th2细胞因子在急性白血病中的表达及意义

目的:探讨调节性T细胞（Tregs）及Th1/Th2型细胞因子在急性白血病发病中的作用。方法:采用流式细胞术检测37例急性白血病患者［包括急性髓细胞性白血病（acute myeloid leukemia，AML）24例，急性淋巴细胞白血病（acute lymphocytic leukemia，ALL）13例］及28例健康对照者外周血CD4+CD25+Foxp3+Tregs的比例，酶联免疫吸附法（ELISA）法检测血浆IL-2、IFN-γ、IL-10、IL-4和TGF-β水平。结果:AML和ALL患者外周血CD4+CD25+Foxp3+Tregs比例均高于健康对照组 (P＜0.05)；AML及ALL患者血浆IL-4、IL-10和TGF-β水平均较健康对照组升高 (P＜0.05)；IFN-γ水平较健康对照组降低 (P＜0.05)；IL-2水平与健康对照组比较无明显差异 (P＞0.05)。结论:Tregs与Th1/Th2细胞因子同时参与了急性白血病的发生；急性白血病患者机体Th1/Th2细胞因子失衡，Th2占优势状态，这可能是导致急性白血病细胞免疫逃逸的原因之一；Tregs可能通过影响Th1/Th2细胞因子平衡参与急性白血病的发病。

Expression and clinical significance of regulatory T cells and Th1/Th2 cytokines in acute leukemia

Objective:To investigate the role of regulatory T cells（Tregs） and Th1/Th2 cytokines in the pathogenesis of acute leukemia.Methods:The proportion of CD4+CD25+Foxp3+Tregs in peripheral blood of 37 patients with acute leukemia and 28 healthy persons were detected by flow cytometry,and the plasma levels of IL-2,IFN-γ,IL-10,IL-4 and TGF-β were determined by ELISA.Results:The proportion of CD4+CD25+Foxp3+ Tregs in acute myeloid leukemia（AML） and acute lymphocytic leukemia（ALL） patients was increased than that of healthy controls (P＜0.05).The plasma levels of IL-10,IL-4 and TGF-β were higher than healthy controls(P＜0.05).The plasma level of IFN-γ was lower than healthy controls(P＜0.05).The plasma level of IL-2 in ALL and AML patients had no difference compared with healthy controls (P＞0.05).Conclusion:Tregs and Th1/Th2 cytokines simultaneously involve in the pathogenesis of acute leukemia.The imbalance of Th1/Th2 cytokines and the dominance of Th2 may be one of the reasons for the immune escape of acute leukemia cells.Tregs may be involved in the pathogenesis of acute leukemia by affecting the balance Th1/Th2 cytokines.