Lad Deepesh P, Varma Subhash, Varma Neelam, Sachdeva Man Updesh Singh, Bose Parveen, Malhotra Pankaj
a Department of Internal Medicine , Post Graduate Institute of Medical Education and Research , Chandigarh , India.
b Department of Hematology , Post Graduate Institute of Medical Education and Research , Chandigarh , India.
Leuk Lymphoma. 2015;56(8):2424-8. doi: 10.3109/10428194.2014.986479. Epub 2015 Jan 21.
The reasons for progression and autoimmune cytopenias (AIC) in chronic lymphocytic leukemia (CLL) are not entirely clear, with previous studies suggesting a role for regulatory T-cells (Treg). In this study we prospectively studied Treg (CD3+CD4+CD25highCD127low), interleukin-10 (IL-10) producing Treg and T-helper 17 (Th17) (CD3+CD4+IL-17+) cells in 40 treatment-naive patients with CLL. The percentage of Th17 and not Treg cells was significantly higher in the AIC cohort than in those without AIC (p<0.0001). The Treg:Th17 ratio was skewed in favor of Th17 in the AIC cohort (p=0.02). Th17 cells are responsible for AIC of CLL. Analysis of lymph-node aspirates showed that the percentage of Treg and IL-10 expression in Treg and not Th17 was significantly higher than in peripheral blood (p<0.01). Treg cells play a major role in the microenvironment where disease progression occurs. This shows the importance of maintaining the Treg:Th17 equilibrium, for imbalance leads to CLL progression or AIC.
慢性淋巴细胞白血病（CLL）病情进展及自身免疫性血细胞减少（AIC）的原因尚不完全清楚，先前的研究表明调节性T细胞（Treg）发挥了一定作用。在本研究中，我们前瞻性地研究了40例初治CLL患者的Treg（CD3 + CD4 + CD25高CD127低）、产生白细胞介素-10（IL-10）的Treg和辅助性T细胞17（Th17）（CD3 + CD4 + IL-17 +）细胞。AIC队列中Th17细胞而非Treg细胞的百分比显著高于无AIC的患者（p<0.0001）。AIC队列中Treg:Th17比值偏向Th17（p = 0.02）。Th17细胞是CLL发生AIC的原因。淋巴结穿刺物分析显示，Treg而非Th17中Treg的百分比及IL-10表达显著高于外周血（p<0.01）。Treg细胞在疾病进展发生的微环境中起主要作用。这表明维持Treg:Th17平衡很重要，因为失衡会导致CLL进展或AIC。
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