Beguin Y, Lampertz S, De Groote D, Igot D, Malaise M, Fillet G
Department of Medicine, University of Liège, Belgium.
Leukemia. 1993 Dec;7(12):2019-25.
We measured the soluble (s) receptors CD23, CD8, CD4, interleukin-2 receptor (IL-2R, CD25), and transferrin receptor (TfR, CD71), in normal serum and in patients with chronic lymphocytic leukemia (CLL) and evaluated them in relation to clinical and biological parameters of the disease, as well as serum immunoglobulin E (IgE). Compared to 31 normal individuals, 42 CLL patients had increased levels of sCD23 (98.4 +/- 127.7 versus 0.9 +/- 0.3 U/ml, p < 0.001), sIL-2R (6080 +/- 7030 versus 1420 +/- 640 pg/ml, p < 0.001), sTfR (12,100 +/- 11,250 versus 5000 +/- 1050 ng/ml, p < 0.001), and sCD8 (510 +/- 191 versus 234 +/- 89 U/ml, p < 0.001), but normal sCD4 levels. Mean sCD23 levels remained normal in patients with non-Hodgkin's lymphoma (other than small lymphocytic), Hodgkin's disease, hairy cell leukemia, acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), multiple myeloma, or solid tumors. Advancing Rai clinical stage was associated with a progressive elevation of sCD23 (p < 0.001), while sCD8 (p < 0.05), sIL-2R (p < 0.001), and sTfR (p < 0.005) were highest in stage 2 patients. Discriminant analysis confirmed the value of soluble receptor determinations in the clinical evaluation of CLL patients. sCD23 correlated with sIL-2R (p < 0.001) and sTfR (p < 0.05) but not with sCD4 or sCD8, and displayed an inverse relationship with serum IgE (NS) and total gamma-globulin (p < 0.05). sIL-2R correlated with sCD23 (p < 0.001), sTfR (p < 0.001), sCD4 (p < 0.01), and sCD8 (p < 0.01). The lymphocyte count correlated with serum lactate dehydrogenase (LDH) (p < 0.05), sCD23 (p < 0.001) and sIL-2R (p < 0.01) but not sTfR, sCD8, or sCD4. Chemotherapy produced consistent reductions of sCD23 levels in two responding patients. We conclude that: (i) sCD23 is considerably elevated in CLL, correlates with the tumor mass and clinical stage, and could be helpful in monitoring these patients; and (ii) sIL-2R, sCD8, and sTfR levels are less specifically increased and could be influenced by other factors such as immune activation and erythropoiesis.
我们检测了正常血清、慢性淋巴细胞白血病（CLL）患者血清中的可溶性（s）受体CD23、CD8、CD4、白细胞介素-2受体（IL-2R，CD25）和转铁蛋白受体（TfR，CD71），并评估了它们与该疾病的临床和生物学参数以及血清免疫球蛋白E（IgE）的关系。与31名正常个体相比，42名CLL患者的sCD23（98.4±127.7对0.9±0.3 U/ml，p<0.001）、sIL-2R（6080±7030对1420±640 pg/ml，p<0.001）、sTfR（12,100±11,250对5000±1050 ng/ml，p<0.001）和sCD8（510±191对234±89 U/ml，p<0.001）水平升高，但sCD4水平正常。非霍奇金淋巴瘤（小淋巴细胞淋巴瘤除外）、霍奇金病、毛细胞白血病、急性淋巴细胞白血病（ALL）、急性髓细胞白血病（AML）、慢性髓细胞白血病（CML）、多发性骨髓瘤或实体瘤患者的平均sCD23水平保持正常。Rai临床分期进展与sCD23逐渐升高相关（p<0.001），而sCD8（p<0.05）、sIL-2R（p<0.001）和sTfR（p<0.005）在2期患者中最高。判别分析证实了可溶性受体测定在CLL患者临床评估中的价值。sCD23与sIL-2R（p<0.001）和sTfR（p<0.05）相关，但与sCD4或sCD8无关，并且与血清IgE（无显著性差异）和总γ-球蛋白呈负相关（p<0.05）。sIL-2R与sCD23（p<0.001）、sTfR（p<0.001）、sCD4（p<0.0`1）和sCD8（p<0.01）相关。淋巴细胞计数与血清乳酸脱氢酶（LDH）（p<0.05）、sCD23（p<0.001）和sIL-2R（p<0.01）相关，但与sTfR、sCD8或sCD4无关。化疗使两名有反应的患者的sCD23水平持续降低。我们得出结论：（i）CLL患者的sCD23显著升高，与肿瘤大小和临床分期相关，可能有助于监测这些患者；（ii）sIL-2R、sCD8和sTfR水平升高的特异性较低，可能受免疫激活和红细胞生成等其他因素影响。
