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探寻输血对胃癌患者的免疫调节作用:外周血中Th1/Th2细胞的流式细胞术检测

Search for immunomodulatory effects of blood transfusion in gastric cancer patients: flow cytometry of Th1/Th2 cells in peripheral blood.

作者信息

Sun C F, Hsieh Y Y, Ngan K W, Wang W T

机构信息

Department of Clinical Pathology, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Tao-Yuan, Taiwan.

出版信息

Ann Clin Lab Sci. 2001 Apr;31(2):171-8.

Abstract

Allogeneic transfusion seems to drive the immune system toward a Th2 response and away from a Th1 response, providing a hypothetical mechanism for transfusion-induced immunomodulation. By means of an intracytoplasmic cytokine detection technique with flow cytometry, it is possible to measure Th1 and Th2 cells derived from peripheral blood mononuclear cells. This study evaluated the presence of transfusion-induced immunomodulation in 11 gastric cancer patients after gastrectomy with perioperative blood transfusion, compared to 11 gastric cancer patients who were treated by gastrectomy without transfusion. Lymphocytes subsets, including CD4 T cells, CD8 T cells, CD4/CD8 Ratio, CD2(+) T cells, CD3(+) T cells, and CD19(+) B cells, were measured in these patients, as well as variables that might suggest transfusion-induced immunomodulation, such as duration of antibiotic use, duration of hospital stay, and total hospital charges. This study also measured changes in the Th1/Th2 ratio. Th1 and Th2 lymphocytes were characterized by measuring intracellular expression of cytokines with flow cytometry. Cells were stimulated with phorbol myristate acetate and ionomycin in the presence of brefeldin-A. The results showed no significant differences in lymphocyte subsets, Th1/Th2 ratio, total hospital charges, or duration of antibiotic utilization between the groups of transfused and non-transfused gastric cancer patients after gastrectomy. The only significant difference was a longer hospital stay for transfused patients (mean 20.5 da) compared to non-transfused patients (mean 16.2 da). The anticipated finding of a Th2 response after blood transfusion was not observed. A larger group of patients may be needed to document such an effect, since many confounding variables affect the morbidity and outcome of surgery in these patients.

摘要

异体输血似乎会促使免疫系统向Th2反应方向发展,远离Th1反应,这为输血诱导的免疫调节提供了一种假设机制。通过流式细胞术的胞内细胞因子检测技术,可以测量外周血单个核细胞衍生的Th1和Th2细胞。本研究评估了11例接受胃切除术并围手术期输血的胃癌患者与11例接受胃切除术但未输血的胃癌患者中输血诱导的免疫调节情况。测量了这些患者的淋巴细胞亚群,包括CD4 T细胞、CD8 T细胞、CD4/CD8比值、CD2(+) T细胞、CD3(+) T细胞和CD19(+) B细胞,以及可能提示输血诱导免疫调节的变量,如抗生素使用时间、住院时间和总住院费用。本研究还测量了Th1/Th2比值的变化。通过流式细胞术测量细胞内细胞因子的表达来鉴定Th1和Th2淋巴细胞。在布雷菲德菌素A存在的情况下,用佛波酯肉豆蔻酸酯和离子霉素刺激细胞。结果显示,胃切除术后输血组和未输血组胃癌患者的淋巴细胞亚群、Th1/Th2比值、总住院费用或抗生素使用时间没有显著差异。唯一显著的差异是输血患者的住院时间(平均20.5天)比未输血患者(平均16.2天)更长。未观察到输血后出现Th2反应这一预期结果。可能需要更大规模的患者群体来证实这种效应,因为许多混杂变量会影响这些患者手术的发病率和结果。

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