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Researches on Expression about Regulatory T Cells in CLL and Its Role in Pathogenesis of CLL Associated AIHA

Author: ZhengXueNa
Tutor: WeiJin
School: North Sichuan Medical College
Course: Internal Medicine
Keywords: Chronic lymphocytic leukemia Autoimmune hemolytic anemia Regulatory T cells Anti-human erythrocyte antibody
CLC: R733.72
Type: Master's thesis
Year: 2011
Downloads: 15
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Abstract


Objective: To analyze chronic lymphocytic leukemia (Chronic lymphocytic leukemia, CLL) in patients with plasma anti-human erythrocyte antibody levels, CD4 CD25 regulatory T cells (CD4 CD25 regulatory T cell, Treg) expression and Treg from CLL autoimmune hemolytic anemia (Autoimmune Hemolytic Anemia, AIHA) relationship, reveal Treg in CLL incidence, progression played role, as well as the impact of chemotherapy on Treg treatment for CLL, reduce the incidence of complications and improve the prognosis of patients provide a reference. Methods: 32 cases of healthy examination center for the normal control group, 29 cases of CLL patients with previously untreated patient group, was diagnosed in 15 patients undergoing chemotherapy, as the part of the CLL patients in the chemotherapy group before chemotherapy, after mutual control. The above test object detection using anti-human globulin (IgG, C3b/C3d) card on the erythrocyte surface immunoglobulin and / complement qualitative detection (direct anti-human globulin test DAT); using three-color direct immunofluorescence fluorescein LABELING cell antigens, such as CD4, CD25, CD3, multi-parameter flow cytometry to detect the normal control group and patients with CLL peripheral blood CD4 CD25 T cells, CD3 T cells gating, Cell Quest Pro software analysis of the normal control group and patients with CLL of CD4 in peripheral blood of CD25 T cells accounted for the proportion of T cells, the CD4 CD25 < sup> high as Treg cells markers; plasma was separated and extracted from peripheral blood mononuclear cells (PBMC) by reverse transcription - polymerase chain reaction (RT-PCR) methods PBMC forked head / winged helix transcription factor (of FoxP3) mRNA expression levels; erythrocyte antibodies by enzyme-linked immunoassay - double-antibody sandwich assay (ELISA) for anti-human plasma IgG concentration, the CLL group were compared with the normal control group, chemotherapy group before chemotherapy and after chemotherapy above differences of each index, and correlation studies explore CLL patients peripheral blood CD25 , the CD4 T cells, changes in the number or proportion of disease progression in the relationship as well as before and after chemotherapy anti-human erythrocyte View the antibody IgG concentration of CD4 of CD25 T cell ratio, FoxP3 mRNA expression level changes in the relationship. Results: 1.CLL cases of patients with DAT positive in 2 cases, the the DAT positive control group, 0 cases. Chemotherapy group DAT positive cases, including three cases before chemotherapy negative to positive. 2.CLL case group plasma anti-human erythrocyte antibody IgG concentration, peripheral blood CD4 of CD25 T cell ratio and PBMC FoxP3 mRNA expression levels were significantly higher than the normal control group ( P lt; 0.05); CLL patients were compared before and after chemotherapy, after chemotherapy in patients with plasma anti-human erythrocyte antibody IgG concentration than before chemotherapy was significantly higher (P lt; 0.05), but of CD4 in peripheral blood CD25 < sup> T cell ratio and PBMC FoxP3 mRNA expression level was significantly lower than that before chemotherapy (P lt; 0.01). Binet stage with CLL progression, Phase A, Phase B and C period of three patients with CD4 CD25 T cells in T cell ratio and peripheral blood FoxP3 mRNA expression of mononuclear cells gradually increased, but the differences between the patients with different stages of the above indicators was no statistical significance (P gt; 0.05). Correlation studies have shown that cases of peripheral blood CD4 CD25 T cells proportion of PBMC FoxP3 mRNA expression was positively correlated (r = 0.683, P lt; 0.01) ; cases plasma anti-human red blood cells the antibody IgG concentration and peripheral blood CD4 CD25 T cell ratio of PBMC of FoxP3 mRNA expression were not related to sex (P gt; 0.05); CLL anti-human red blood cells after chemotherapy in patients plasma the antibody IgG concentration and peripheral blood CD4 of CD25 T cell ratio (r = -0.529, P = 0.043) of PBMC of FoxP3 mRNA expression was negatively correlated resistance (r = -0.596, P = 0.019). Conclusion: The proportion and number of regulatory T cells in the peripheral blood of patients with CLL increased with the progression of the disease, the proportion and quantity of a growing trend. Chemotherapy will result in the number of T cells in the peripheral blood of patients with CLL regulatory reduce imbalance, this change of regulatory T cells may be one of the pathogenesis of CLL-related AIHA.

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CLC: > Medicine, health > Oncology > Hematopoietic and lymphoid neoplasms > Leukemia > Chronic leukemia
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