急性白血病患者血清中白细胞介素-21的表达及其意义

目的探讨白细胞介素-21在急性白血病患者血清中的表达情况及其意义。方法选择符合标准的65例白血病患者,根据疾病发生情况分成急性淋巴细胞性白血病(ALL)组(31例)与急性髓性细胞白血病(AML)组(34例),测定常规化疗前后患者血清IL-21水平。结果 ALL组与AML组血清IL-21水平均显著高于健康组(P0.05),且ALL组显著高于AML组(P0.05)。ALL组女性患者血清IL-21值均显著性高于ALL组男性患者与AML女性患者(P0.05)。在ALL组与AML组中,IL-21R阳性患者于IL-21R阴性患者在WBC与外周血幼稚细胞水平上存在显著性差异(P0.05)。结论通过检测患者血清中的IL-21水平能够用于辅助诊断急性白血病,同时区分ALL与AML,具有一定的临床价值,值得临床进行推广并进一步深入研究。     

急性白血病患者血清IFN-γ、TGF-β、IL-6和IL-17水平及临床意义

目的 研究急性白血病患者血清干扰素-γ(IFN-γ)、转化生长因子-β(TGF-β)、白介素-6(IL-6)和IL-17表达情况以及临床意义.方法 选取2014年4月-2016年3月收治的96例急性白血病患者为观察对象,按FAB分型标准分为急性淋巴细胞白血病(ALL)组35例,急性髓细胞白血病(AML)组61例.另选同期健康体检者96例为对照组.采用酶联免疫吸附法检测急性白血病患者治疗前后及对照组血清IFN-γ、TGF-β、IL-6和IL-17的表达情况.结果 治疗前,ALL组与AML组血清IFN-γ水平明显低于对照组(P＜0.05),TGF-β、IL-6、IL-17水平明显高于对照组(P＜0.05).ALL组血清IFN-γ与IL-6水平高于AML组(P＜0.05).ALL组和AML组治疗后,完全缓解患者血清IFN-γ水平高于未缓解患者(P＜0.05),TGF-β、IL-6和IL-17水平低于未缓解患者(P＜0.05).ALL组和AML组中,IFN-γ与TGF-β、IL-6和IL-17呈负相关(P＜0.05),TGF-β与IL-6和IL-17呈正相关(P＜0.05),IL-6与IL-17呈正相关(P＜0.05).结论血清IFN-γ 、TGF-β、IL-6和IL-17与急性白血病的发生、发展有关,可作为临床诊断急性白血病与评价其预后的重要指标.     

急性髓系白血病应用重组人白介素-2联合乌苯美司维持治疗的临床研究

急性白血病是一种常见的造血系统疾病,其特征是白血病细胞获得增殖、生存优势且不能分化成熟。过多的无功能的白血病细胞抑制正常造血,且侵袭其它组织器官引起功能障碍,最终导致死亡。急性髓系白血病（AML）应用重组人白介素-2（IL-2）联合乌苯美司维持治疗可通过增强细胞免疫功能,干扰肿瘤细胞代谢,促进抗肿瘤效应细胞的产生和增殖等作用而降低AML复发,提升患者生存质量,使患者生存期明显延长。     

Neuropilin-1及其配体SemaphorinIII在AML和正常人骨髓中的表达初探

目的 :了解neuropilin_1基因及其配体semaphorinIII在急性髓性白血病 (AML)骨髓中的表达情况。方法 :利用逆转录_聚合酶链反应扩增20例急性髓性白血病病人骨髓单个核细胞中的neuropilin_1基因及其配体semaphorinIII基因 ,了解其表达情况。14例非血液病患者的骨髓标本作为对照。结果 :急性髓性白血病骨髓单个核细胞中的neuropilin_1基因表达率为15 0% ,semaphorinIII基因表达率为60 0% ,分别与相应正常对照(7 1 % ,57 1% )相比较无显著性差异。结论 :参与调控骨髓基质细胞的neuropilin_1基因及其配体semaphorinIII可表达于AML和正常人的骨髓细胞中 ,该结果为进一步了解此两类基因在造血中的调节作用提供了基础资料     

急性白血病患者血清IL-3、IL-6及IL-8水平的变化及意义

目的 探讨急性白血病(AL)患者治疗前后血清白细胞介素(IL)3、IL-6、IL-8水平的变化及意义.方法 采用酶联免疫法(ELISA),对94例初诊AL患者治疗前后血清IL-3、IL-6、IL-8水平进行检测.结果 急性淋巴细胞白血病(ALL)与急性髓细胞白血病(AML)初诊患者血清IL-3水平均明显低于正常对照组(P＜0.01),而血清IL-6、IL-8水平均明显高于正常对照组(P＜0.01);经治疗ALL完全缓解(CR)患者血清IL-3、IL-6、IL-8水平恢复正常,而AML-CR患者血清IL-3水平较初诊时明显升高(P＜0.01),但仍明显低于正常对照(P＜0.01),IL-6、IL-8水平恢复正常;ALL未缓解(NR)及AML-NR组与初诊组相比无性差异(P＞0.05).AML初诊患者血清IL-3水平与ALL-初诊患者无显著性差异,IL-6水平明显低于ALL患者(P＜0.05),而IL-8水平明显高于ALL患者(P＜0.01).AML各亚型之间血清IL-3水平无显著性差异;M1及M5患者血清IL-6水平明显高于其他亚型(P＜0.01);M4及M5患者血清IL-8水平明显高于其他亚型(P＜0.01).结论 IL-3、IL-6、IL-8与AL发生发展有关,其水平与AL类型有关,观察IL-3、IL-6、IL-8水平的变化可作为判断AL患者病情及疗效的辅助指标.     

Neuropilin-1及其配体Semaphorin Ⅲ在AML 和正常人骨髓中的表达初探

目的：了解neuropilin-1基因及其配体semaphorin Ⅲ在急性髓性白血病（AML）骨髓中的表达情况。方法：利用逆转录－聚合酶链反应扩增20例急性髓性白血病病人骨髓单个核细胞中的neuropilin-1基因及其配体semaphorin Ⅲ基因，了解其表达情况。14例非血液病患者的骨髓标本作为对照。结果：急性髓性白血病骨髓单个核细胞中的neuropilin-1基因表达率为15．0％，semaphorin Ⅲ基因表达率为60．0％，分别与相应正常对照（7．1％，57．1％）相比较无显著性差异。结论：参与调控骨髓基质细胞的neuropilin-1基因及其配体semaphorin Ⅲ可表达于AML和正常人的骨髓细胞中，该结果为进一步了解此两类基因在造血中的调节作用提供了基础资料。     

白细胞介素-11研究进展

白细胞介素-11是骨髓基质细胞分泌的一种多功能造血调控因子,对造血干细胞,尤其是对巨核细胞具有重要的调控作用,对脂肪细胞、胃肠道上皮细胞等亦具有明显的生物学活性。临床试验表明,IL-11能使肿瘤患者的血小板升高,对巨核细胞集落形成单位及血小板有调控作用。在临床上,特别是对患者的化放疗及骨髓移植治疗具有临床应用价值。     

急性髓系白血病的药物治疗

急性白血病(AL)按细胞形态学、细胞化学染色可分为急性淋巴系白血病(ALL)和急性髓系或非淋巴系白血病(AML、ANLL)两大类;按病因可分原发性和继发性,前者病因不明,后者继发于慢性白血病急变、骨髓增殖异常综合征(MDS)转化、慢性骨髓增殖性疾病(CMPD)转化和治疗相关性(放疗、药物)所致,均为造血干细胞克隆性疾病.     

急性白血病患者血清及脑脊液中基质细胞衍生因子-1α的检测意义

目的探讨急性白血病(AL)患者血清及脑脊液(CSF)基质细胞衍生因子-1α(SDF-1α)的表达水平及临床意义。方法采用酶联免疫吸附法(ELISA)分别检测初诊、未治和经标准方案化疗2个疗程后的56例AL患者以及10例同期颅脑外伤患者(对照组)的血清及CSF中SDF-1α的水平。结果初诊未治时,急性淋巴细胞白血病(ALL)组、急性髓细胞白血病(AML)组、中枢神经系统白血病(CNSL)组和非中枢神经系统白血病(N-CNSL)组血清、CSF中SDF-1α浓度均明显高于对照组(P<0.01),且ALL组明显高于AML组(P<0.01),CNSL组明显高于N-CNSL组(P<0.01)。经标准方案化疗2个疗程后与治疗前比较,ALL组和AML组血清、CSF中SDF-1α水平均明显降低(P<0.01)。AL患者经标准方案化疗2个疗程后未缓解(NR)组血清、CSF中SDF-1α浓度明显高于完全缓解(CR)组(P<0.01)。经标准化疗方案治疗2个疗程后,CNSL组血清、CSF中SDF-1α浓度明显高于N-CNSL组(P<0.01)。结论 SDF-1α可作为AL特别是CNSL患者的病情检测指标,有助于判断病情发展、估计预后,其表达与AL的分型可能具有一定相关性。     

急性早幼粒细胞白血病治疗体会

急性白血病(AL)系造血系统恶性克隆性疾病。按FAB分类,AL分为急性淋巴细胞白血病(ALL)和急性髓性白血病(AML)。急性早幼粒细胞白血病(APL)属FAB分类中M3型AML。APL是一种独特类型的AML,以特殊的形态学、超微结构、细胞遗传学和临床表现为特征。该型白血病出血倾向严重,易并发弥     

The use of hematopoietic growth factors in the treatment of acute leukemia

Cytokines are centrally involved in the regulation of normal hematopoiesis, the production of mature blood cells by bone marrow stem cells. Cytokines influence stem survival, proliferation, and differentiation commitment, as well as controlling the orderly maturation of progenitor cells into functional leucocytes, erythrocytes, and platelets. Acute leukemias result from malignant transformation of bone marrow stem cells. Although cytokines do not appear to be centrally involved in the pathogenesis of acute leukemias, leukemic cells express receptors for many of the cytokines regulating normal hematopoiesis, particularly G-CSF, GM-CSF, IL-3, and stem cell factor. These molecules have demonstrable effects on acute leukemia cells in vitro, inducing proliferation and enhancing survival, but their biological activity when administered as recombinant proteins in pharmaceutical doses to patients with active leukemia are less well understood. Because of the stimulatory effects of cytokines such as G-CSF and GM-CSF on normal hematopoiesis in vitro and in normal individuals, these two molecules have been extensively studied in randomised clinical trials of chemotherapy for cancer, including acute leukemia. Concerns about the potential for G-CSF and GM-CSF to accelerate the growth of acute myeloid leukemia, which expresses receptors for both molecules, have not been realised. Conversely, the concept of using either of these two cytokines to induce acute myeloid leukemia cells into active DNA synthesis, thus potentially sensitising them to the effects of S-phase-specific drugs, has not been shown to be clinically beneficial. Both G-CSF and GM-CSF have been demonstrated to accelerate the recovery of normal granulopoiesis after intensive initial cytotoxic chemotherapy for acute leukemia, significantly shortening the duration of severe treatment-induced neutropenia, and resulting in a number of tangible benefits including reduction in infection, use of intravenous antibiotics, and duration of hospital stay. However, the final role for these agents in the treatment of acute leukemia remains controversial and still to be fully defined.     

全反式维甲酸对人骨髓基质细胞分泌GM-CSF的影响

目的:探讨全反式维甲酸对骨髓基质细胞分泌GM-CSF的影响.方法:原代培养正常人和急性早幼粒细胞白血病患者的骨髓基质细胞,ELISA法检测不同浓度维甲酸对正常和急性早幼粒细胞白血病骨髓基质细胞分泌GM-CSF的差异.结果:不同浓度全反式维甲酸对正常和急性早幼粒细胞白血病骨髓基质细胞分泌GM-CSF浓度存在差异,维甲酸呈浓度依赖性调高正常和急性早幼粒细胞白血病患者骨髓基质细胞分泌GM-CSF浓度.结论:维甲酸可能通过骨髓基质细胞分泌GM-CSF而促进造血,间接诱导细胞分化治疗.     

急性白血病化疗中钝顶螺旋藻对血细胞的作用

采用化疗对５２例急性白血病进行治疗，其中４１例加用螺旋藻辅助治疗。化疗结束后均有明显的骨髓抑制，加用螺旋藻组则使抑制期缩短，更早地进入骨髓恢复期且外周血细胞上升幅度明显，本研究表明，螺旋藻在辅助化疗中有修复正常造血，促使血细胞上升的作用。     

刺梨汁对骨髓抑制小鼠造血功能的调控作用

目的探讨刺梨汁对环磷酰胺合并60Co致骨髓抑制小鼠造血功能的影响,研究其促进血细胞上调的作用机制。方法双抗体夹心法检测外周血常规、骨髓基质中红细胞生成素（EPO）、血小板生成素（TPO）、粒细胞生长因子（GCSF）的量。结果刺梨汁能明显改善骨髓抑制小鼠外周血常规,能有效平衡微环境中TPO的量,改善EPO的表达,对骨髓抑制小鼠骨髓细胞上清中GCSF有明显的正调控作用。结论刺梨汁能提高骨髓抑制小鼠外周血血细胞和骨髓有核细胞计数,可促进骨髓抑制小鼠骨髓细胞从G0/G1期进入增殖周期,并能有效调节骨髓微环境中TPO、EPO、GCSF的表达,从而促进骨髓抑制小鼠的造血功能,可作为一种治疗贫血的辅助保健药物。     

Effects of neopterin on the hematopoietic microenvironment of senescence-accelerated mice (SAM)

The pteridine neopterin (NP) is produced by monocytes and is known to be a useful marker of immunological activation, although, it remains elusive whether neopterin itself exhibits biological functions. Recently, we found that NP stimulates hematopoietic cell proliferation and differentiation by activating bone marrow stromal cell function. In order to elucidate the biological effect of NP on stromal cells, its effects on hematopoiesis was determined in the mouse model of age-related stromal impairment, senescence-accelerated mice (SAMs). An intraperitoneal administration of NP increased the number of peripheral leukocytes and CFU-GM in the bone marrow and spleen of young SAMs, however, no increase of CFU-GM in old SAMs (stromal impairment) was observed when compared with young SAMs. NP also increased the CFU-GM colony formation of bone marrow and spleen cells from young SAMs in a soft agar culture system, but it did not enhance CFU-GM colony formation of cells from old SAMs cultured in this system. Treatment with NP induced the production of hematopoietic stimulating factors, including IL-6 and GM-CSF, by bone marrow stromal cells from young SAMs but stromal cells from old SAMs did not respond to NP stimulation. Further studies will be required to clarify the mechanism by which NP stimulates the production of hematopoietic growth factors from stromal cells, the results of this study indicate that NP is a potent hematopoietic regulatory factor by activating stromal cell function(s).     

骨髓微环境与骨髓增生异常综合征

骨髓增生异常综合征 （MDS） 是一组起源于造血干细胞 （HSC） 的异质性克隆性疾病, 特点是髓系细胞一系或多系发育异常, 表现为无效造血、 外周血细胞减少, 高风险向急性髓系白血病 （AML） 转化。MDS的发病、 造血功能改变及预后与骨髓微环境密切相关。骨髓微环境是一个复杂的网络系统, 其中基质细胞包括间充质干细胞的形态和功能异常、 成骨细胞分化受损、 血管内皮细胞数量增加、 单核/巨噬细胞数量减少都会促进MDS发病; 细胞因子如肿瘤坏死因子-α （TNF-α） 过表达、 血管内皮生长因子 （VEGF） 及基质细胞衍生因子-1 （SDF-1） 表达异常也与MDS发病密切相关; 基因如Dicer1低表达、 AURKA高表达、 SPINT2低表达均会促进MDS发病; Wnt/β-catenin信号通路的异常激活、 异常的PI3K/AKT及Hh信号通路也参与MDS的发病、 进展。对MDS和骨髓微环境相互作用的研究, 将进一步阐明该病的发病机制、 进展和预后, 并有助于靶向治疗的发展。本文就MDS中骨髓微环境基质细胞、 细胞因子、 基因、 信号通路异常的研究进展进行综述。     

重组人白介素1α引起小鼠骨髓基质细胞膜超极化

重组人白介素１α引起小鼠骨髓基质细胞膜超极化１吴曙光肖学军徐伟鲍永耀（第一军医大学药物研究所，广州５１０５１５）白介素１（ｉｎｔｅｒｌｅｕｋｉｎ－１，ＩＬ－１）是具有广泛生物学活性的多肽，其生物活性通过受体介导［１］，但至今有关ＩＬ－１与受体结合后的...     

Human bone marrow fibroblastic cells can inhibit clonogenic growth of K562 cells

The influence of human bone marrow fibroblastic cells (FC) on the proliferation of K562 leukemic colony-forming cells (LCF-C) was studied. FC derived from normal subjects and patients with acute leukemia were used. The growth of LCF-C was evaluated by colony-forming efficiency in soft agar. Inhibition of leukemic colony formation was produced by FC from normal subjects and patients with acute leukemia. While the degree of inhibition by FC from patients with acute lymphocytic leukemia was almost the same as that by those from the normal subjects, that by FC from patients with acute nonlymphocytic leukemia was lower than that by those from normal individuals. Both conditioned media obtained from FC and contact of their FC with LCF-C in dishes for four hr inhibited leukemic colony formation. These data show that leukemic stem cells are inhibited by bone marrow FC through cell-to-cell contact or humoral factors derived from FC.     

人参总皂甙对小鼠骨髓基质细胞RNA表达及其细胞因子诱生的影响

采用胶片法（细胞贴壁胶片生长法）及放射自显影等技术，较系统地观察了人参总甙（ＴＧＳ）对小鼠骨髓基质细胞ＲＮＡ表达的时相特点及对细胞因子ＩＬ－３、１１－６诱生的影响。结果表明．ＴＧＳ在体外对小鼠骨髓基质细胞ＲＮＡ的代谢有明显的促进效应．并且发现骨髓基质细胞实验上清中ＩＬ－３、ＩＬ－６因子的活性显著高于正常对照组。在此基础上。又利用放射自显影技术做为胶片法可行性的佐证．取得满意结果。