Department of clinical laboratory, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Department of hematology-oncology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Cytokine. 2023 Nov;171:156378. doi: 10.1016/j.cyto.2023.156378. Epub 2023 Sep 23.
The aim of this study is to investigate the clinical potential of immune microenvironment in peripheral blood for the severity and therapeutic efficacy of Langerhans cell histiocytosis (LCH). A total of 200 newly diagnosed children with LCH during 10 years was enrolled for analysis in this study. Peripheral blood samples were acquired from patients before treatment in our hospital and immune indicators were detected by a four-color flow cytometer. The levels of CD3 + CD8 + T cell, CD3 + CD4 + HLA-DR + T cell, CD3 + CD8 + HLA-DR + T cell, IL-4, IL-6, IL-10 and IFN-γ in peripheral blood were markedly elevated in LCH patients vs. healthy controls. Patients with multiple system with risk organ involvement (MS-RO + ) exhibited higher levels in IL-6, IL-10 and IFN-γ, CD3 + CD4 + HLA-DR + T cell and CD3 + CD8 + HLA-DR + T cell, compared to those in patients without risk organ involvement (RO-). Patients who responded effectively to initial chemotherapy showed significantly lower levels of IL-4, IL-10, IFN-γ, CD3 + CD4 + HLA-DR + T cell and CD3 + CD8 + HLA-DR + T cell in peripheral blood, compared to those in patients who did not respond to initial chemotherapy. Furthermore, univariate analyses were performed that the higher levels of CD3 + CD4 + HLA-DR + T cells, CD3 + CD8 + HLA-DR + T cells and IL-10 in peripheral blood were related to non-response in LCH after initial chemotherapy. Immune microenvironment in peripheral blood may be associated with the severity and treatment response of LCH. The levels of CD3 + CD4 + HLA-DR + T cells, CD3 + CD8 + HLA-DR + T cells and IL-10 may be biomarkers to predict treatment response of LCH patients.
本研究旨在探讨郎格汉斯细胞组织细胞增生症（LCH）患者外周血免疫微环境与疾病严重程度和治疗疗效的临床相关性。本研究共纳入了 200 例在我院接受治疗的新诊断为 LCH 的儿童患者。采集患者治疗前的外周血样本，采用四色流式细胞仪检测免疫指标。结果显示，与健康对照组相比，LCH 患者外周血中 CD3+CD8+T 细胞、CD3+CD4+HLA-DR+T 细胞、CD3+CD8+HLA-DR+T 细胞、IL-4、IL-6、IL-10 和 IFN-γ水平明显升高。伴有多系统合并风险器官受累（MS-RO+）的患者，其外周血中 IL-6、IL-10 和 IFN-γ、CD3+CD4+HLA-DR+T 细胞和 CD3+CD8+HLA-DR+T 细胞水平较无风险器官受累（RO-）的患者更高。对初始化疗反应有效的患者，其外周血中 IL-4、IL-10、IFN-γ、CD3+CD4+HLA-DR+T 细胞和 CD3+CD8+HLA-DR+T 细胞水平明显低于初始化疗无反应的患者。此外，单因素分析显示，外周血中 CD3+CD4+HLA-DR+T 细胞、CD3+CD8+HLA-DR+T 细胞和 IL-10 水平升高与 LCH 患者初始化疗后无反应有关。外周血免疫微环境可能与 LCH 的严重程度和治疗反应有关。CD3+CD4+HLA-DR+T 细胞、CD3+CD8+HLA-DR+T 细胞和 IL-10 水平可能是预测 LCH 患者治疗反应的生物标志物。
