再生障碍性贫血患者血清sFasL、SDF-1与免疫抑制疗效的相关性

doi:10.11958/20240702

天津医药 ›› 2024, Vol. 52 ›› Issue (12): 1270-1273.doi: 10.11958/20240702

再生障碍性贫血患者血清sFasL、SDF-1与免疫抑制疗效的相关性

张玉龙¹(), 张静¹, 李树军¹, 马龙¹, 祖建兵¹^,^△(), 孙丹丹²

1 兴安盟人民医院检验科（邮编137400）
2 血液科

收稿日期:2024-06-04 修回日期:2024-08-30 出版日期:2024-12-15 发布日期:2024-12-17
通讯作者: △E-mail：18548218026@163.com
作者简介:张玉龙（1990），男，主管检验师，主要从事临床血液检验方面研究。E-mail：u0th0g@163.com
基金资助:
兴安盟科技计划项目(MJXM2019MB10)

Correlation of serum levels of sFasL, SDF-1 and immunosuppressive efficacy in patients with aplastic anemia

ZHANG Yulong¹(), ZHANG Jing¹, LI Shujun¹, MA Long¹, ZU Jianbing¹^,^△(), SUN Dandan²

1 Department of Laboratory
2 Department of Blood Specialty, Hinggan League People's Hospital, Ulanhot 137400, China

Received:2024-06-04 Revised:2024-08-30 Published:2024-12-15 Online:2024-12-17
Contact: △E-mail：18548218026@163.com

张玉龙, 张静, 李树军, 马龙, 祖建兵, 孙丹丹. 再生障碍性贫血患者血清sFasL、SDF-1与免疫抑制疗效的相关性[J]. 天津医药, 2024, 52(12): 1270-1273.

ZHANG Yulong, ZHANG Jing, LI Shujun, MA Long, ZU Jianbing, SUN Dandan. Correlation of serum levels of sFasL, SDF-1 and immunosuppressive efficacy in patients with aplastic anemia[J]. Tianjin Medical Journal, 2024, 52(12): 1270-1273.

摘要/Abstract

摘要：

目的探究再生障碍性贫血（AA）患者血清可溶性凋亡相关因子配体（sFasL）、基质细胞衍生因子1（SDF-1）水平及其与免疫抑制治疗效果的相关性。方法选择接受半年免疫抑制治疗的AA患者43例为观察组，另择43例同期健康体检者为对照组。观察组患者进行免疫抑制治疗和促造血治疗，并依据疗效分为无效组和有效组。收集患者临床资料，采用酶联免疫吸附试验检测血清sFasL、SDF-1、肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）水平，分析血清sFasL与SDF-1水平的相关性，多因素Logistic回归分析AA患者免疫抑制治疗效果的影响因素，受试者工作特征（ROC）曲线分析血清sFasL、SDF-1对免疫抑制治疗效果的预测价值。结果观察组血清sFasL、SDF-1水平均高于对照组（P<0.05）。无效组血清TNF-α、IL-8、sFasL、SDF-1水平均高于有效组（P<0.05）。AA患者血清sFasL水平与SDF-1水平呈正相关（r=0.534，P<0.001）。血清sFasL、SDF-1水平升高是AA患者免疫抑制治疗无效的独立危险因素（P<0.05）。血清sFasL、SDF-1联合预测AA患者免疫抑制治疗效果的曲线下面积（AUC）为0.973（95%CI：0.872~0.999），优于各自单独预测（P<0.05），其敏感度和特异度分别为94.44%和96.00%。结论 AA患者血清sFasL、SDF-1水平均明显升高，二者联合检测对AA免疫抑制治疗效果具有较高的预测价值。

关键词: 贫血, 再生障碍性, 免疫耐受, 可溶性凋亡相关因子配体, 基质细胞衍生因子1

Abstract:

Objective To investigate serum levels of soluble apoptosis-related factor ligand (sFasL) and stromal cell derived factor 1 (SDF-1) in patients with aplastic anemia (AA) and their correlation with immunosuppressive treatment. Methods Forty-three AA patients who received immunosuppressive therapy for half a year were selected as the observation group, and another 43 healthy subjects at the same period were selected as the control group. Patients in the observation group received immunosuppressive therapy and hematopoietic propoietic therapy, and patients were divided into the ineffective group and the effective group according to the efficacy. Clinical data of patients were collected, and serum levels of sFasL, SDF-1, tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) were detected by enzyme-linked immunosorbent assay. The correlation between serum sFasL and SDF-1 levels was analyzed. Multivariate Logistic regression analysis was conducted to analyze influencing factors of immunosuppressive treatment in AA patients. The predictive values of serum sFasL and SDF-1 on immunosuppressive treatment were analyzed by receiver operating characteristic (ROC) curve. Results Serum levels of sFasL and SDF-1 were higher in the observation group than those in the control group (P<0.05). Serum levels of TNF-α, IL-8, sFasL and SDF-1 were higher in the ineffective group than those in the effective group (P<0.05). Serum sFasL level was positively correlated with SDF-1 level in AA patients (r=0.534, P<0.001). Increased serum sFasL and SDF-1 levels were independent risk factors for ineffective immunosuppressive therapy in AA patients (P<0.05). The area under the curve (AUC) of serum sFasL and SDF-1 combined to predict the immunosuppressive treatment effect of AA patients was 0.973 (95%CI: 0.872-0.999), which was better than that of single diagnosis (P<0.05), and its sensitivity and specificity were 94.44% and 96.00%, respectively. Conclusion Serum levels of sFasL and SDF-1 are significantly increased in patients with AA. The combined detection of sFasL and SDF-1 has high predictive value for the immunosuppressive treatment effect of AA.

Key words: anemia, aplastic, immune tolerance, soluble apoptosis related factor ligand, stromal cell derived factor 1

中图分类号:

R556.5

图/表 5

参考文献 19

[1]	PATEL B A, TOWNSLEY D M, SCHEINBERG P. Immunosuppressive therapy in severe aplastic anemia[J]. Semin Hematol, 2022, 59(1):21-29. doi:10.1053/j.seminhematol.2022.01.002.
[2]	GROARKE E M, PATEL B A, SHALHOUB R, et al. Predictors of clonal evolution and myeloid neoplasia following immunosuppressive therapy in severe aplastic anemia[J]. Leukemia, 2022, 36(9):2328-2337. doi:10.1038/s41375-022-01636-8.
[3]	PATEL B A, GROARKE E M, LOTTER J, et al. Long-term outcomes in patients with severe aplastic anemia treated with immunosuppression and eltrombopag:a phase 2 study[J]. Blood, 2022, 139(1):34-43. doi:10.1182/blood.2021012130.
[4]	FURLONG E, CARTER T. Aplastic anaemia:Current concepts in diagnosis and management[J]. J Paediatr Child Health, 2020, 56(7):1023-1028. doi:10.1111/jpc.14996.
[5]	WALLACH-DAYAN S B, PETUKHOV D, AHDUT-HACOHEN R, et al. sFasL-the key to a riddle:immune responses in aging lung and disease[J]. Int J Mol Sci, 2021, 22(4):2177. doi:10.3390/ijms22042177.
[6]	WALLACH-DAYAN S B, ROJAS M. Senescence,the janus of lung injury and repair[J]. Am J Respir Cell Mol Biol, 2020, 62(5):548-549. doi:10.1165/rcmb.2020-0022ED.
[7]	SADRI F, REZAEI Z, FEREIDOUNI M. The significance of the SDF-1/CXCR4 signaling pathway in the normal development[J]. Mol Biol Rep, 2022, 49(4):3307-3320. doi:10.1007/s11033-021-07069-3.
[8]	WANG Y, LAN W, XU M, et al. Cancer-associated fibroblast-derived SDF-1 induces epithelial-mesenchymal transition of lung adenocarcinoma via CXCR4/β-catenin/PPARδ signalling[J]. Cell Death Dis, 2021, 12(2):214. doi:10.1038/s41419-021-03509-x.
[9]	中华医学会血液学分会红细胞疾病(贫血)学组. 再生障碍性贫血诊断治疗专家共识[J]. 中华血液学杂志, 2010, 31(11):790-792.
	Group of the Hematology Branch of the Chinese Medical Association. Expert consensus on diagnosis and treatment of aplastic anemia in the red blood cell disease (Anemia)[J]. Chin J Hematol, 2010, 31(11):790-792. doi:10.3760/cma.j.issn.0253-2727.2010.11.022.
[10]	GIUDICE V, SELLERI C. Aplastic anemia:Pathophysiology[J]. Semin Hematol, 2022, 59(1):13-20. doi:10.1053/j.seminhematol.2021.12.002.
[11]	SCHEINBERG P. Novel therapeutic choices in immune aplastic anemia[J]. F1000Res, 2020, 9(1):1-6. doi:10.12688/f1000research.22214.
[12]	PODEROSO T, DE LA RIVA P M, ÁLVAREZ B, et al. CD200R family receptors are expressed on porcine monocytes and modulate the production of IL-8 and TNF-α triggered by TLR4 or TLR7 in these cells[J]. Mol Immunol, 2022, 144(2):166-177. doi:10.1016/j.molimm.2022.02.019.
[13]	LORENTE L, RODRIGUEZ S T, SANZ P, et al. Patients with hepatocellular carcinoma that die during the first year of liver transplantation have high blood sFasL concentrations[J]. World J Clin Cases, 2023, 11(8):1753-1760. doi:10.12998/wjcc.v11.i8.1753.
[14]	NAREZNOI D, KONIKOV-ROZENMAN J, PETUKHOV D, et al. Matrix metalloproteinases retain soluble FasL-mediated resistance to cell death in fibrotic-lung myofibroblasts[J]. Cells, 2020, 9(2):411. doi:10.3390/cells9020411.
[15]	LORENTE L, MARTÍN M M, ORTIZ-LÓPEZ R, et al. Association between serum sFasL concentrations and sepsis mortality[J]. Infect Dis(Lond), 2021, 53(1):38-43. doi:10.1080/23744235.2020.1819560.
[16]	QIN H, ZHAO X, HU Y J, et al. Inhibition of SDF-1/CXCR4 axis to alleviate abnormal bone formation and angiogenesis could improve the subchondral bone microenvironment in osteoarthritis[J]. Biomed Res Int, 2021, 2021:8852574. doi:10.1155/2021/8852574.
[17]	JIANG Q, HUANG K, LU F, et al. Modifying strategies for SDF-1/CXCR4 interaction during mesenchymal stem cell transplantation[J]. Gen Thorac Cardiovasc Surg, 2022, 70(1):1-10. doi:10.1007/s11748-021-01696-0.
[18]	FU X, LIU G, HALIM A, et al. Mesenchymal stem cell migration and tissue repair[J]. Cells, 2019, 8(8):784. doi:10.3390/cells8080784.
[19]	高靖, 王秀艳, 杨红梅, 等. 急性缺血性脑卒中患者血清SDF-1、UCH-L1水平变化及其与病情程度和预后的关系[J]. 山东医药, 2021, 61(25):46-48.
	GAO J, WANG X Y, YANG H M, et al. Changes in serum SDF-1 and UCH-L1 levels in patients with acute ischemic stroke and their relationship with disease severity and prognosis[J]. Shandong Med J, 2021, 61(25):46-48. doi:10.3969/j.issn.1002-266X.2021.25.011.

组别	n	sFasL/（ng/L）	SDF-1/（μg/L）
对照组	43	586.24±115.37	113.87±13.41
观察组	43	723.53±187.73	132.32±18.25
t		4.086^＊	5.345^＊

组别	n	sFasL/（ng/L）	SDF-1/（μg/L）
对照组	43	586.24±115.37	113.87±13.41
观察组	43	723.53±187.73	132.32±18.25
t		4.086^＊	5.345^＊

组别	n		性别（男/女）	年龄/岁		确诊至免疫抑制治疗时间/d		病因（原发/肝炎后/妊娠/药物）		WBC/ （×10⁹/L）		NEU/（×10⁹/L）		LYM/（×10⁹/L）		RET/（×10⁹/L）
有效组	25		13/12	27.12±3.15		54.15±6.08		13/8/3/1		3.85±0.79		0.83±0.10		3.82±0.71		20.06±4.45
无效组	18		10/8	27.56±3.05		54.32±6.12		8/5/4/1		3.98±0.83		0.89±0.12		3.96±0.86		19.58±4.33
χ²或t			0.053	0.453		0.090		0.910		0.523		1.762		0.546		0.353
组别		CD3⁺/%			CD4⁺/%		CD8⁺/%		TNF-α/（ng/L）		IL-8/（ng/L）		sFasL/（ng/L）		SDF-1/（μg/L）
有效组		65.38±7.02			28.16±3.13		42.32±4.68		150.78±22.63		63.61±7.34		613.67±112.78		123.18±14.52
无效组		65.14±6.83			27.68±3.15		42.05±4.37		192.26±31.18		88.52±11.15		876.12±163.46		145.03±15.21
χ²或t		0.116			0.495		0.192		5.060^＊		8.276^＊		5.879^＊		4.773^＊

组别	n		性别（男/女）	年龄/岁		确诊至免疫抑制治疗时间/d		病因（原发/肝炎后/妊娠/药物）		WBC/ （×10⁹/L）		NEU/（×10⁹/L）		LYM/（×10⁹/L）		RET/（×10⁹/L）
有效组	25		13/12	27.12±3.15		54.15±6.08		13/8/3/1		3.85±0.79		0.83±0.10		3.82±0.71		20.06±4.45
无效组	18		10/8	27.56±3.05		54.32±6.12		8/5/4/1		3.98±0.83		0.89±0.12		3.96±0.86		19.58±4.33
χ²或t			0.053	0.453		0.090		0.910		0.523		1.762		0.546		0.353
组别		CD3⁺/%			CD4⁺/%		CD8⁺/%		TNF-α/（ng/L）		IL-8/（ng/L）		sFasL/（ng/L）		SDF-1/（μg/L）
有效组		65.38±7.02			28.16±3.13		42.32±4.68		150.78±22.63		63.61±7.34		613.67±112.78		123.18±14.52
无效组		65.14±6.83			27.68±3.15		42.05±4.37		192.26±31.18		88.52±11.15		876.12±163.46		145.03±15.21
χ²或t		0.116			0.495		0.192		5.060^＊		8.276^＊		5.879^＊		4.773^＊

自变量	β	SE	Wald χ²	P	OR（95%CI）
TNF-α	-0.749	1.018	0.541	0.462	0.473（0.064~3.479）
IL-8	-1.027	1.214	0.716	0.397	0.358（0.033~3.866）
sFasL	0.860	0.279	9.491	0.002	2.362（1.367~4.081）
SDF-1	0.922	0.327	7.955	0.005	2.515（1.325~4.774）
常数项	0.357	0.174	4.210	0.040	1.429

再生障碍性贫血患者血清sFasL、SDF-1与免疫抑制疗效的相关性

Correlation of serum levels of sFasL, SDF-1 and immunosuppressive efficacy in patients with aplastic anemia

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变量	AUC	95%CI	截断值	敏感度/%	特异度/%	约登指数
sFasL	0.867	0.728~0.951	623.92 ng/L	88.89	72.00	0.609
SDF-1	0.849	0.707~0.940	132.34 μg/L	77.78	84.00	0.618
联合	0.973	0.872~0.999	-	94.44	96.00	0.904

[1]	马汇擎, 刘洋. 外周动静脉换血技术在新生儿疾病中的应用[J]. 天津医药, 2023, 51(5): 556-560.
[2]	丁宇斌 , 唐玉凤 , 唐旭东 . 获得性再生障碍性贫血克隆演变的研究进展[J]. 天津医药, 2019, 47(9): 994-997.
[3]	王凯, 高伟. 供体特异性调节性T细胞在肝移植免疫耐受中的意义[J]. 天津医药, 2019, 47(11): 1196-1200.
[4]	韩冰，李红敏，陈芳菲，伍洁. 骨髓增生异常综合征贫血原因及治疗策略[J]. 天津医药, 2018, 46(8): 794-798.
[5]	石武娟, 穆郁, 宋立, 张芳, 麻庆荣, 王丹. 抗-E及抗-Ec合并抗-Fyb致新生儿溶血症二例及文献复习[J]. 天津医药, 2018, 46(6): 654-656.
[6]	吴玉红, 邵宗鸿. 再生障碍性贫血感染的研究进展[J]. 天津医药, 2018, 46(12): 1342-1346.
[7]	张珊，宋新龙，王爱迪，谢东杰，张乐，刘宝山△. CD4+T细胞的分化调节及其在再生障碍性贫血中作用的研究进展[J]. 天津医药, 2018, 46(10): 1123-1126.
[8]	李颖曦陈丹王小东景亚青李克秋李光. 丹柴合剂对树突状细胞的诱导分化作用[J]. 天津医药, 2016, 44(3): 318-321.
[9]	董艳 1,2，徐为人 1，孔德新 2△. 促红细胞生成素拟肽研究进展[J]. 天津医药, 2015, 43(1): 102-105.
[10]	李颖曦1 ,陈丹2 ,李克秋3 ,李光4 . 调节性树突状细胞的获取途径及其诱导免疫耐受的临床应用[J]. , 2014, 42(7): 725-727 .
[11]	闫永嘉何向辉. IL-35及其免疫抑制功能的研究进展[J]. 天津医药, 2014, 42(12): 1243-1245.
[12]	周曼,刘启英,赵钿,许吟,陈铭希,李贵芳,黄盛文. 不同孕周新生儿脐血血红蛋白电泳结果分析[J]. , 2013, 41(4): 307-309 .
[13]	于万有. 亚急性肝衰竭贫血发生的临床特征及意义[J]. , 2013, 41(4): 390-391 .
[14]	闫永嘉1 ,付蔚华2 ,高莹1 ,朱理玮1 . 分子嵌合MHC-Ⅰ基因小鼠骨髓造血干细胞输注降低脾脏T细胞对异基因小鼠DC反应的研究[J]. , 2012, 40(4): 378-380 .
[15]	孔方方. 2001—2011年全国驻军医院妊娠期贫血的调查研究?[J]. , 2012, (10): 1060-1061 .