The clinical significance of Th17 cell heterogeneity in myelodysplastic neoplasms

doi:10.11958/20250670

Abstract

Abstract:

Objective To investigate the proportion of Th17 cells, Th1-like Th17 cells and FoxP3⁺Th17 cells in bone marrow of patients with myelodysplastic syndrome (MDS), the expression of interleukin-17A (IL-17A) in bone marrow supernatant and its clinical significance. Methods Forty MDS patients (MDS group) and 18 patients with nutritional anemia (control group) were selected. MDS patients were classified into the low blast (MDS-LB) group (19 cases) and the increased blast (MDS-IB) group (21 cases, including 11 cases of type IB1 and 10 cases of type IB2) based on morphological definition. The MDS patients were scored according to the revised International Prognostic Scoring System (IPSS-R), with 18 cases in the low-risk group (≤4.5) and 22 cases in the high-risk group (>4.5). Flow cytometry was used to detect the proportion of Th17 cells, Th1-like Th17 cells and FoxP3⁺Th17 cells in bone marrow of the MDS group and the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of IL-17A in bone marrow supernatant of the above samples. Results The proportion of Th17 cells and the level of IL-17A were higher in patients of the MDS group than those in the control group (P<0.05). According to the median expression level of IL-17A, the MDS group was divided into the low-expression group (<13.71 ng/L, 20 cases) and the high-expression group (≥13.71 ng/L, 20 cases). Compared with the low-expression group, there were higher proportion of patients with blast cells <5% and low-risk patients (P<0.05) in the high-expression group. Compared with the IL-17A low-expression group, the IL-17A high-expression group had a higher proportion of patients with blast cells <5% and relatively low-risk patients (P<0.05). Compared with the low-risk patients, high-risk patients had a lower proportion of Th17 cells, IL-17A levels and Th1-like Th17 cells, and a higher proportion of FoxP3⁺Th17 cells (P<0.05). Compared with the MDS-LB group, the MDS-IB group had a lower proportion of Th17 cells, IL-17A levels and Th1-like Th17 cells, and a higher proportion of FoxP3⁺Th17 cells (P<0.05). Conclusion The proportion of Th17 cells and the level of IL-17A are significantly increased in MDS patients. The decreased proportion of Th1-like Th17 cells and the increased proportion of FoxP3⁺Th17 cells may be related to the increased proportion of blast cells and higher risk stratification in patients.

Key words: Th17 cells, heteroplasmy, interleukin-17, myelodysplastic neoplasms

CLC Number:

R551.3

Figures/Tables 5

References 22

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组别	n	原始细胞比例		危险度
组别	n	<5%	≥5%	低危	高危
低表达组	20	4（20.0）	16（80.0）	5（25.0）	15（75.0）
高表达组	20	15（75.0）	5（25.0）	13（65.0）	7（35.0）
χ²		12.130^＊＊		6.465^＊

组别	n	原始细胞比例		危险度
组别	n	<5%	≥5%	低危	高危
低表达组	20	4（20.0）	16（80.0）	5（25.0）	15（75.0）
高表达组	20	15（75.0）	5（25.0）	13（65.0）	7（35.0）
χ²		12.130^＊＊		6.465^＊

组别	n	Th17细胞/%	IL-17A/（ng/L）
低危组	18	3.04（2.27，4.25）	18.72（11.30，21.98）
高危组	22	2.01（1.13，2.63）	12.27（7.42，14.84）
Z		2.719^＊＊	2.542^＊

组别	n	Th17细胞/%	IL-17A/（ng/L）
低危组	18	3.04（2.27，4.25）	18.72（11.30，21.98）
高危组	22	2.01（1.13，2.63）	12.27（7.42，14.84）
Z		2.719^＊＊	2.542^＊

组别	n	Th17细胞/%	IL-17A/（ng/L）
MDS-LB组	19	3.25（2.31，4.11）	18.31（13.73，21.90）
MDS-IB组	21	1.83（1.07，2.47）	9.92（6.91，13.98）
Z		3.291^＊＊	3.277^＊＊