多发性骨髓瘤患者骨髓中Treg/Th17细胞失衡研究

本研究通过检测多发性骨髓瘤（MM）患者骨髓微环境中调节性T细胞（Treg）和Th17细胞的比例,探讨Treg/Th17细胞失衡与多发性骨髓瘤发生发展的关系.应用流式细胞术检测37例MM患者和12例正常对照者骨髓中Treg和Th17细胞的表达量,对其中19例MM患者同时检测了外周血中Treg和Th17细胞的表达量.结果表明：MM组骨髓中Treg细胞比例高于正常对照组（P＜0.05）,自ISS分期的Ⅰ＋Ⅱ期至Ⅲ期逐渐增高（P＜0.05）;进一步研究发现,MM患者骨髓中Treg细胞水平高于外周血,差异有统计学意义（P＜0.05）.MM组骨髓中Th17细胞比例与正常对照组无差别（P＞0.05）,临床分期间无差别（P＞0.05）.MM患者骨髓中TH17细胞比例与外周血无差别（P＞0.05）.MM组Treg/Th17的比值高于正常对照组（P＜0.05）,自ISS分期的Ⅰ＋Ⅱ期至Ⅲ期逐渐增高（P＜0.05）.结论MM患者骨髓微环境中存在Treg/Th17比例失衡,这种失衡可能促进了MM的病程进展.

Imbalance of Treg/Th17 in Bone Marrow of Patients with Multiple Myeloma

The purpose of this study was to detect the distribution of Treg and Th17 cells in bone marrow and to investigate the relationship of Treg/Th17 imbalance with the pathogenesis and progression of multiple myeloma（MM）.The Bone marrow was collected from 37 MM patients and 12 healthy volunteers,the ratio of Treg and Th17 cells was detected by flow cytometry.The expression of Treg and Th17 cells simultaneously was examined in peripheral blood of 19 MM patients with same method.The results indicated that the frequency of Treg cells was higher in MM patients than that in control group （P 〈 0.05）,there was a trend of increasing of Treg cell number in the ISS stage from Ⅰ ＋ Ⅱ to Ⅲ （P 〈 0.05）.Furthermore,in the patients with MM,the Treg cell number in bone marrow was higher than that in peripheral blood（P 〈 0.05）.Th17 cell rate was not statistically different between MM patients and control group （P 〉 0.05）,and at different ISS stage （P 〉 0.05）.Th17 cell number between bone marrow and peripheral blood was not significantly different （P 〉 0.05）.The ratio of Treg/Th17 in patients with MM was higher than that in control group （P 〈 0.05）,and increased gradually from ISS stage Ⅰ ＋ Ⅱ to stage Ⅲ （P 〈 0.05）.It is concluded that the Treg/Th17 immune imbalance is presenced in bone marrow of patients with MM,this imbalance may promote the progression of MM.