İmatinib Tedavisi Alan Hastalarda T Lenfosit Aktivasyonunun Akım Sitometrik Analizi

Öz

İmatinibin in vivo ortamda T lenfosit fonksiyonları üzerine olan etkileri akım sitometrik olarak değerlendirilmiştir.  Çalışmaya toplam 29 KML hastası ve 9 sağlıklı birey dahil edilmiştir. KML hastaları kendi aralarında sırasıyla, yeni tanı almış ve tedavi görmeyen, 1 yıldır imatinib alan ve 1 yıldan uzun süredir imatinib alan hastalar olarak 3 gruba ayrılmıştır. CD4+ hücreler ve bu hücrelerdeki IL-4 ve IFNg ifadeleri, CD3+ T lenfositlerin % kaçının aktive edilmiş olduğu (CD3+CD69+), CD8+ hücreler ve bu hücrelerde HLA-ABC ve HLA-DR ifade eden hücrelerin oranı ve HLA-ABC ve HLA-DR ifadelerinin şiddeti değerlendirilmiştir. Gruplar arasında ortalama CD4 + hücre sayısı açısından anlamlı fark yoktu. Bununla birlikte, kontrol grubunda daha yüksek CD4 + hücrelerine doğru bir eğilim vardı. IL-4 ve IFN gama, gruplar arasında istatistiksel olarak anlamlı bulunmadı. Kontrol grubu daha düşük IL-4 ve IFN gama ifade değerlerine sahipti. IL-4 ve IFN gama ifade etmeyen ortalama CD4 + hücre sayısı kontrol grubunda diğer gruplara göre istatistiksel olarak daha yüksekti. Kontrol grubunda ise % aktivasyon diğer gruplara göre azdı. Tüm hasta gruplarında CD8 + hücre oranı istatistiksel olarak daha düşük bulundu (p = 0,001). HLA-ABC ve HLA-DR'nin CD8 + hücrelerinde ekspresyonu gruplar arasında benzerdi. İmatinibin sitokin sentezi üzerine herhangi bir etkisi gözlenmemiştir. İmatinib tedavisi altındaki hastalarda T lenfosit fonksiyonlarının etkilendiğine dair klinik belirgin gözlemler olmamakla birlikte, subklinik etki varlığı araştırma konusudur. Yapılan in vitro çalışmaların in-vivo korele olup olmadığının aydınlatılabilmesi için daha ileri çalışmalara gereksinim vardır. 

Anahtar Kelimeler

• kronik miyelositer lösemi,akım sitometri,imatinib,T hücre

Flow Cytometric Analysis of T Lymphocyte Activation in CML Patients Under Imatinib Therapy

Öz

To analyze T cell functions by flow cytometry and to evaluate the possible functional changes that might occur under imatinib therapy in CML patients. A total of 29 patients and 9 healthy control subjects were enrolled. Newly diagnosed patients having no treatment (group 1), patients receiving imatinib for 1 year (group 2) and patients receiving imatinib more than 1 year (group 3), healthy control subjects (group 4). IL-4 and IFN gamma expression on CD4+ cells; how much percentage of CD3+ T cells were activated (CD3+CD69+); CD8+ T cells and the ratio and grade of expression of HLA-ABC and HLA-DR on those cells were evaluated, respectively.

There was no significant difference in terms of mean number of CD4+ cells between the groups. However, there was a tendency towards higher CD4+ cells in control group. IL-4 and IFN gamma were found not to be statistically significant between the groups. Control group has lower IL-4 and IFN gamma expression values. Mean number of CD4+ cells, which did not express IL-4 and IFN gamma, were statistically higher in control group when compared to other groups. In control group, % activation was decreased when compared to that of other groups. CD8+ cell ratio was found to be statistically lower in all patient groups (p=0.001). The expression of HLA-ABC and HLA-DR on CD8+ cells were similar between the groups. We could not show any inhibitory effect of imatinib on T cell functions in concordance with clinical experience and safety profile. 

Anahtar Kelimeler

• chronic myelogenous leukemia,flow cytometry,imatinib,T cell

Kaynakça

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