【摘要】 目的:研究急性白血病（AL）患者免疫微环境,揭示AL免疫逃逸的机制,为有效的免疫治疗提供理论依据。方法:应用ELISA方法检测AL患者血浆中干扰素γ（IFN-γ）、白细胞介素10（IL-10）的浓度,采用间接免疫荧光法检测AL患者白血病细胞IL-10的表达。结果:①AL初发患者血浆中IFN-γ浓度较正常对照组明显降低,经化疗完全缓解（CR）后,IFN-γ浓度较治疗前无显著变化,且较治疗前略降低;AL初发患者血浆中IL-10浓度较正常对照组显著升高,经化疗CR后,IL-10浓度较治疗前显著降低,但仍明显高于正常对照组。②血浆中IFN-γ、IL-10的浓度与外周血白细胞总数及幼稚细胞百分比无关。AL患者经化疗后,CR者、PR者、耐药死亡者治疗前血浆中IFN-γ浓度依次降低,IL-10浓度依次升高。结论:AL初发患者体内以Th₂型细胞因子占优势,且白血病细胞分泌IL-10,造成肿瘤局部的免疫抑制状态,可能是AL免疫逃逸的重要机制之一。更多还原

【Abstract】 Objective:To study the acute leukemia local microenvironment, reveal the mechanisms of the acute leukemia immune escape,and provide the theoretical foundation for effective immunotherapy. Method:Plasma concentrations of IFN-γ and IL-10 were measured in acute leukemia patients by ELISA. The expression of IL-10 on leukemic cells was measured by indirect immunofluorescence technique. Result: (1) Compared with healthy controls , the IFN-γ concentrations decreased significantly in acute leukemia patients de novo. After intensive chemotherapy, there was no significant difference in IFN-γ concentrations between leukemia and the CR patients, but a slight decrease in CR; Compared with healthy controls, the IL-10 concentrations increased significantly. After intensive chemotherapy, there was a significant decrease of IL-10 in CR patients, but there was a significant increase compared with healthy controls. (2) Plasma concentrations of IFN-γ and IL-10 were not correlated with the leukocyte counts, the percentage of blast cells in peripheral blood. IFN-γ concentrations before intensive chemotherapy in CR, PR, death patients decreased successively, but IL-10 increased successively. Conclusion:Th2 type cytokines dominated in acute leukemia de novo, and the leukemic cells secreted IL-10, contributed to the immunosuppressive state at the tumor site. This is probably one of important mechanisms of immune escape.更多还原