Zabernigg A, Hilbe W, Eisterer W, Greil R, Ludescher C, Thaler J
Department of Internal Medicine, University of Innsbruck, Austria.
Leuk Lymphoma. 1997 Sep;27(1-2):137-43. doi: 10.3109/10428199709068280.
Increased susceptibility to infections in patients with myelodysplastic syndromes (MDS) is thought to be due to neutropenia as well as functional abnormalities of neutrophils. In the present study we examined the effect of two different stimulants (fMLP, PMA) and three cytokines (alphaTNF, G-CSF and GM-CSF), both singly and in combination on granulocyte (RB) in 25 MDS patients compared to seven healthy controls. Single fMLP and PMA-stimulation showed similar results for both groups. Preincubation with cytokines enhanced fMLP-stimulated RB in most MDS patients and controls, but in patients to a significantly lesser extent when compared to the control group (p < or = 0,05). Combinations of alphaTNF + GM-CSF and alphaTNF + G-CSF were highly synergistic in priming fMLP-stimulated burst in both groups. But again, as with the single cytokine priming this effect was markedly reduced in MDS patients compared to controls (p < or = 0,05). A specific priming defect for one of the cytokines or a cytokine combination could not be demonstrated. Serum alphaTNF levels were measured in 18 and neutrophil alkaline phosphatase (NAP) index in 23 patients. Results did not correlate with variations of the RB in MDS patients. We conclude that reduced alphaTNF, GM-CSF and G-CSF priming of granulocyte RB is a frequent finding in MDS and may contribute to the enhanced susceptibility to bacterial infections.
骨髓增生异常综合征（MDS）患者对感染的易感性增加被认为是由于中性粒细胞减少以及中性粒细胞功能异常所致。在本研究中，我们检测了两种不同的刺激剂（fMLP、PMA）和三种细胞因子（αTNF、G-CSF和GM-CSF）单独及联合使用对25例MDS患者粒细胞（RB）的影响，并与7名健康对照者进行了比较。单剂量fMLP和PMA刺激在两组中显示出相似的结果。细胞因子预孵育增强了大多数MDS患者和对照者中fMLP刺激的RB，但与对照组相比，患者增强的程度明显较小（p≤0.05）。αTNF+GM-CSF和αTNF+G-CSF的组合在两组中对fMLP刺激的爆发具有高度协同作用。但同样，与单一细胞因子预孵育一样，与对照组相比，MDS患者的这种作用明显降低（p≤0.05）。未发现针对其中一种细胞因子或细胞因子组合的特异性预孵育缺陷。对18例患者检测了血清αTNF水平，对23例患者检测了中性粒细胞碱性磷酸酶（NAP）指数。结果与MDS患者RB的变化无关。我们得出结论，粒细胞RB的αTNF、GM-CSF和G-CSF预孵育降低在MDS中是常见现象，可能导致对细菌感染的易感性增加。
