TNF 作为白血病患者化疗期间口腔念珠菌病、HSV 感染和粘膜炎发病的标志物。
TNF as marker of oral candidiasis, HSV infection, and mucositis onset during chemotherapy in leukemia patients.
机构信息
Master's Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, México.
Biochemical Unit, Department of Genomic Medicine and Environmental Toxicology, Biomedical Research Institute, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Universidad Nacional Autónoma de México, Mexico City, México.
出版信息
Oral Dis. 2017 Oct;23(7):941-948. doi: 10.1111/odi.12677. Epub 2017 May 16.
OBJECTIVE
To assess changes in the salivary expression of IL-1α, IL-1β, IL-2, IL-6, IL-10, IL-17, and TNF in acute leukemia (AL) patients before and during chemotherapy, and its association with HSV infection, oral candidiasis (OC), and oral mucositis (OM) onset.
METHODS
Cohort study in AL patients >15 years starting induction chemotherapy at a Mexican oncological center (2013-2014). Onset of oral lesions (OLs) was assessed during follow-up, and saliva was obtained at baseline, at visit 2 (days 4-12), and at visit 3 (days 13-21) after chemotherapy, treated with a protease inhibitor and stored at -70°C. An enzyme-linked immunosorbent assay was performed. Cox proportional hazards regression models were constructed to estimate hazard ratios and its 95% CI (HR, 95% CI) for OL development.
RESULTS
Forty-one patients were followed up, and 17 (41.5%) developed OLs. OL patients had higher baseline salivary IL-1α than those without lesions (p = 0.040). During visit 2, OL patients had higher levels of IL-1α (p = 0.033), IL-1β (p = 0.016), IL-6 (p = 0.035), and TNF (p = 0.019) than those who did not develop OLs. Patients with HSV infection, OC, and OM showed higher salivary TNF levels during follow-up (HR: 3.52, 95% CI: 1.35-9.14, p = 0.010).
CONCLUSION
AL patients undergoing chemotherapy with high salivary TNF levels were more likely to develop HSV infection, OC, and OM.
目的
评估急性白血病（AL）患者在化疗前后唾液中白细胞介素 1α（IL-1α）、白细胞介素 1β（IL-1β）、白细胞介素 2（IL-2）、白细胞介素 6（IL-6）、白细胞介素 10（IL-10）、白细胞介素 17（IL-17）和肿瘤坏死因子（TNF）表达的变化，及其与单纯疱疹病毒（HSV）感染、口腔念珠菌病（OC）和口腔黏膜炎（OM）发病的关系。
方法
这是一项在墨西哥肿瘤中心进行的 15 岁以上 AL 患者队列研究，于 2013-2014 年开始诱导化疗。在随访期间评估口腔病变（OLs）的发病情况，并在化疗后第 2 天（第 4-12 天）和第 3 天（第 13-21 天）采集基线唾液，用蛋白酶抑制剂处理并储存在-70°C。采用酶联免疫吸附试验（ELISA）检测。构建 Cox 比例风险回归模型来估计 OL 发病的危险比及其 95%置信区间（HR，95%CI）。
结果
共 41 例患者进行了随访，其中 17 例（41.5%）发生 OLs。OL 患者的基线唾液 IL-1α 水平高于无病变患者（p=0.040）。在第 2 次就诊时，OL 患者的 IL-1α（p=0.033）、IL-1β（p=0.016）、IL-6（p=0.035）和 TNF（p=0.019）水平均高于未发生 OLs 的患者。HSV 感染、OC 和 OM 患者在随访期间的 TNF 水平较高（HR：3.52，95%CI：1.35-9.14，p=0.010）。
结论
化疗后唾液 TNF 水平较高的 AL 患者更易发生 HSV 感染、OC 和 OM。
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