Dong Qin-Min, Li Hai-Yun, Lei Fu-Zhen, Yang Ru-Yu
Department of Composition, Quality Control Section of Nanyang Central Blood Station, Nanyang 473000, Henan Province, China.
Department of Hematology, Nanyang Central Hospital, Nanyang 473000, Henan Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018 Aug;26(4):999-1004. doi: 10.7534/j.issn.1009-2137.2018.04.009.
To investigate the effect of leukodepleted blood transfusions on peripheral blood Th1/Th2 cell balance in patients with acute lymphoblastic leukemia (ALL).
Fifty-seven ALL patients in our hospital from March 2016 to August 2017 were selected, 31 of them received routine blood transfusion were enrolled in group A, and 26 patients received depleted-blood leukotransfusion were enrolled in group B, 36 cases in normal physical examination at the same period were enrolled in control group. And the basic clinical characteristics of patients were recorded; the ratio of Th1/Th2 cells in peripheral blood of patients was analyzed by flow cytometry;the serum levels of IL-2, IFN-γ, IL-4, IL-10 were detected by ELISA method; the mRNA levels of T-bet and GATA-3 in lymphocytes were detected by RT-PCR;the protein levels of T-bet and GATA-3 in lymphocyte were detected by Western blot.
The Th1/Th2 ratio in peripheral blood of ALL patients significantly related with patient age and risk grade (P<0.05).After treatment,the change of Th1/Th2 ratio in group A showed no statistical difference from Th1/Th2 ratio before treatment (P>0.05), while the Th1/Th2 ratio in group B increased (P<0.05);the levels of IL-2, IFN-γ, IL-4 and IL-10 secreted from Th1 and Th2 cells of ALL patients in A group were not changed significantly(P>0.05), while the levels of IL-2 and IFN-γ secreted from Th1 cells of ALL patients in group B increased, the levels of IL-4 and IL-10 secreted from Th2 cells in group B decreased with statistical difference (P<0.05); the RT-PCR and Western blot showed that the expression levels of T-bet mRNA and T-bet protein in group A were lower than those in control group, while the expression levels of T-bet mRNA and T-bet protein in group B were higher than those in group A (P<0.05); the expression levels of mRNA and GATA-3 protein in group A were higher than those in control group, the expression levels of mRNA and GATA-3 protein in group B were lower than those in group A (P<0.05).
The leukoreduced blood transfusion helps to improve the balance of Th1/Th2 cells in peripheral blood and improve the immune function of patients, which may closely relate with the expression levels of T-bet and GATA-3.
探讨去白细胞输血对急性淋巴细胞白血病(ALL)患者外周血Th1/Th2细胞平衡的影响。
选取2016年3月至2017年8月我院收治的57例ALL患者,其中31例接受常规输血的患者纳入A组,26例接受去白细胞输血的患者纳入B组,同期36例健康体检者纳入对照组。记录患者的基本临床特征;采用流式细胞术分析患者外周血Th1/Th2细胞比例;采用酶联免疫吸附测定(ELISA)法检测患者血清白细胞介素-2(IL-2)、γ干扰素(IFN-γ)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)水平;采用逆转录聚合酶链反应(RT-PCR)检测淋巴细胞中T-bet和GATA-3的mRNA水平;采用蛋白质免疫印迹法检测淋巴细胞中T-bet和GATA-3的蛋白水平。
ALL患者外周血Th1/Th2比值与患者年龄和危险度分级显著相关(P<0.05)。治疗后,A组Th1/Th2比值变化与治疗前比较差异无统计学意义(P>0.05),而B组Th1/Th2比值升高(P<0.05);A组ALL患者Th1和Th2细胞分泌的IL-2、IFN-γ、IL-4和IL-10水平变化均无统计学意义(P>0.05),而B组ALL患者Th1细胞分泌的IL-2和IFN-γ水平升高,B组Th2细胞分泌的IL-4和IL-10水平降低,差异有统计学意义(P<0.05);RT-PCR和蛋白质免疫印迹法结果显示,A组T-bet mRNA和T-bet蛋白表达水平低于对照组,而B组T-bet mRNA和T-bet蛋白表达水平高于A组(P<0.05);A组GATA-3 mRNA和GATA-3蛋白表达水平高于对照组,B组GATA-3 mRNA和GATA-3蛋白表达水平低于A组(P<0.05)。
去白细胞输血有助于改善ALL患者外周血Th1/Th2细胞平衡,提高患者免疫功能,其机制可能与T-bet和GATA-3表达水平密切相关。