检验医学 ›› 2012, Vol. 27 ›› Issue (7): 601-605.

• 免疫学检验论著 • 上一篇    下一篇

骨髓中CD4+CD25highFoxp3+调节性T细胞与儿童急性B淋巴细胞白血病的相关性研究

蒋黎敏1,徐翀2,傅启华3   

  1. 1.上海交通大学医学院附属上海儿童医学中心检验科,上海 200127;2.上海市临床检验中心免疫室,上海 200126
  • 收稿日期:2012-03-01 修回日期:2012-04-19 出版日期:2012-07-30 发布日期:2012-07-05
  • 通讯作者: 傅启华
  • 作者简介:蒋黎敏,男,1978年生,学士,主管技师,主要从事医学检验工作。

Research on correlation of bone marrow CD4+CD25highFoxp3+ regulatory T cells with childhood acute B lymphoblastic leukemia

  1. 1.Department of Clinical Laboratory,Shanghai Children Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;2. Department of Immunology Laboratory,Shanghai Center for Clinical Laboratory,Shanghai 200126,China
  • Received:2012-03-01 Revised:2012-04-19 Online:2012-07-30 Published:2012-07-05
  • Contact: Qihua Fu

摘要: 目的 通过检测急性B淋巴细胞白血病(B-ALL)患儿骨髓中叉状头/翅膀状螺旋转录因子(Foxp3) mRNA的表达及CD4+细胞中调节性T细胞(Treg)比例,探讨Treg与儿童B-ALL发生及预后的关系。方法 用实时定量聚合酶链反应(PCR)检测10名正常儿童、35例初发B-ALL患儿及68例临床缓解患儿骨髓中Foxp3 mRNA水平;用流式细胞术检测上述骨髓标本中CD4+CD25highFoxp3+ Treg的比例;利用酶联免疫吸附试验(ELISA)检测骨髓中细胞因子白细胞介素10(IL-10)的表达情况。结果 骨髓中Foxp3 mRNA表达水平在B-ALL初发患儿组是对照组的4.44倍,微小残留病(MRD)阳性组是阴性组的2.39倍;B-ALL初发患儿骨髓中Treg占CD4+T淋巴细胞的比例[中位数(M)=12.77%]较对照组(M=8.09%)增高,差异具有统计学意义(P<0.01);MRD阳性组 Treg比例(M=14.74%)与MRD持续阴性组(M=11.30%)比较,差异具有统计学意义(P<0.05)。治疗后MRD阳性组骨髓中IL-10水平[(24.69±11.73)pg/mL]显著高于MRD持续阴性组[(9.19±5.82) pg/mL,P<0.05]。结论 B-ALL初发和MRD阳性患儿骨髓中Foxp3 mRNA水平和Treg比例显著增高,且骨髓中IL-10水平与Treg的比例变化趋势相一致。Treg可作为评价B-ALL患儿预后和复发的指标,Treg可能是通过分泌抑制性细胞因子IL-10而发挥其抑制作用。

关键词: 调节性T细胞, 叉状头/翅膀状螺旋转录因子, 急性B淋巴细胞白血病, 微小残留病

Abstract: Objective To analyze the forkhead box protein 3(Foxp3) mRNA expression and the CD4+ regulatory T cells(Treg) frequency in the bone marrow of childhood acute B lymphoblastic leukemia(B-ALL),and to investigate the relationship between Treg and the development and prognosis of childhood B-ALL. Methods The levels of Foxp3 mRNA were detected in 35 children with B-ALL,68 patients with remission and 10 healthy controls by real-time polymerase chain reaction(PCR). The CD4+ CD25highFoxp3+ Treg were identified by flow cytometry. The interleukin-10(IL-10) expression level in bone marrow was detected by enzyme-linked immunosorbent assay(ELISA). Results The level of Foxp3 mRNA expression in B-ALL group was 4.44 times higher than that of control group. In minimal residual disease(MRD) positive group,it was 2.39 times higher than that in MRD negative group. The percentage median(M) of Treg in CD4+T cells was 12.77% in B-ALL group,which was significantly higher than that in control group(8.09%,P<0.01). In addition,Treg frequency in MRD positive group(M=14.74%) was significantly different from that in MRD continuously negative group(M=11.30%,P<0.05).The level of IL-10 in MRD positive group was(24.69±11.73)pg/mL,which was higher than that of MRD continuously negative group[(9.19±5.82)pg/mL,P<0.05]. Conclusions The frequency of Treg and Foxp3 mRNA are significantly elevated in patients with childhood B-ALL and patients with positive MRD,and the IL-10 level in bone marrow is consistent with the frequency of Treg. Treg can be used to evaluate the prognosis and relapse of childhood B-ALL,and may play its role by secreting inhibitory cytokine IL-10.

Key words: Regulatory T cell, Forkhead box protein 3, Acute B lymphoblastic leukemia, Minimal residual disease