标题：Th22 Cells as Well as Th17 Cells Expand Differentially in Patients with Early-Stage and Late-Stage Myelodysplastic Syndrome
作者：Shao, Lin-lin; Zhang, Lei; Hou, Yu; Yu, Shuang; Liu, Xin-guang; Huang, Xiao-yang; Sun, Yuan-xin; Tian, Tian; He, Na; Ma, Dao-xin; 更多 作者机构：[Shao, Lin-lin; Yu, Shuang; Liu, Xin-guang; Sun, Yuan-xin; Tian, Tian; He, Na; Ma, Dao-xin; Peng, Jun; Hou, Ming] Shandong Univ, Qilu Hosp, Dept Hemat 更多
通讯作者地址：[Ma, DX]Shandong Univ, Qilu Hosp, Dept Hematol, Jinan 250100, Peoples R China.
摘要：Background: Immunological mechanisms are increasingly recognized in the progression of myelodysplastic syndrome (MDS). Early-stage MDS (E-MDS) is characterized by autoimmune-mediated myelosuppression whereas late-stage MDS (L-MDS) involves immune evasion, giving dysplastic cells growth potential to progress into acute myeloid leukemia. T-helper (Th) 22 is involved in the pathogenesis of inflammatory autoimmunity and tumorigenesis. The roles of Th22 cells in the pathophysiology of E-MDS and L-MDS remain unsettled.; Design and Methods: We studied 37 MDS patients (E-MDS, n = 17; L-MDS, n = 20) and 20 healthy controls to characterize their peripheral blood (PB), as well as 25 MDS patients and 10 healthy controls to characterize their bone marrow(BM). The expression of Interleukin-22 (IL-22), IL-17 or interferon gamma (IFN-gamma) was examined in E-MDS, L-MDS patients and controls by flow cytometry. The mRNA expression levels of RAR-related orphan receptor C (RORC), IL-6, tumor necrosis factor alpha (TNF-alpha) and IL-23 in peripheral blood mononuclear cells (PBMCs) were determined by real-time quantitative polymerase chain reaction. The levels of IL-22 and IL-17 both in PB and BM plasma were examined by enzyme-linked immunosorbent assay.; Results: In E-MDS, peripheral Th17 cells were significantly elevated and correlated with peripheral Th22 cells compared with healthy controls and L-MDS. Significantly higher levels of peripheral Th22 expansion, mRNA expression of IL-6, TNF-alpha and lower level of RORC mRNA expression were observed in L-MDS compared with E-MDS. No statistical difference was found in IL-23 mRNA expression or plasma IL-22, IL-17 levels among E-MDS, L-MDS and controls.; Conclusions: Our data demonstrated that L-MDS cohort had increased frequencies of peripheral Th22 cells and higher mRNA expression levels of IL-6 and TNF-alpha, indicating that Th22 cells along with Th17 cells or not are involved in the dynamic immune responses of MDS.