OBJECTIVE:To investigate the expression and significance of PD-1/PD-L1 in MDS blast cells, T lymphocyte cell subsets and Treg cells. METHODS:Eighty-eight MDS patients and 19 AML patients were collectd as the study subjects, and Iron deficiency anemia and healthy bone marrow donors were used as control group. The expression of PD-1/PD-L1 in MDS/AML blast cells, T lymphocyte cell subsets and Treg cells was detected by flow cytometry, and the expression level of Th1/Th2/Th17-related cytokines in peripheral serum was detected. RESULTS:The expression of PD-1/PD-L1 in blast cells, T lymphocyte cell subsets and Treg cells in low risk MDS group were lower than that in control group, medium and high risk MDS group and AML group（all P < 0.01）, and Th1/Th17 type cytokines were dominant. The expression of PD-1/PD-L1 in blast cells, T lymphocyte cell subsets and Treg cells of intermediate and high risk MDS group and AML group were higher than that of control group and low risk MDS group (all P < 0.01), and Th2 type and Treg type (IL-10、TGF-β) cytokines were dominant. After treatment, the differences of PD-1/PD-L1 expression were not statisticatly significant in blast cells, T lymphocyte cell subsets and Treg cells between the MDS remission group and the control group (all P >0.05). The expression of PD-1/PD-L1 in blast cells, T lymphocyte cell subsets and Treg cells in MDS non-remission group were significantly higher than that in remission group and control group (all P < 0.01). CONCLUSION:The high expression of PD-1/PD-L1, dominance of Treg (IL-10、TGF-β) and Th2-related cytokines and inhibition of effector T lymphocyte cells in patients with MDS is conducive to tumor cell proliferation and immune escape, which may promote the progression of MDS disease.

OBJECTIVE:To investigate the levels of cytokines in the plasma of patients with multiple myeloma(MM), and explore its clinical significance. METHODS:The levels of 6 cytokines(IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ) in the plasma of 59 newly diagnosed MM patients and 30 healthy controls were retrospectively analyzed, and the immunophenotypes were also analyzed. The plasma levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ were quantitatively detected by flow microsphere technology, and the differences of cytokines levels in each group were tested by Wilcoxon. RESULTS:The plasma concentration of IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ in MM patients were all significantly higher than those in healthy controls (P<0.05). According to the ISS staging, there were no statistically significant difference in cytokines levels of patients at each stage (P>0.05). MM patients with high CD56 expression had higher plasma levels of IL-6 than the CD56 low expression group (41.74±62.73 vs 6.31±5.60 pg/ml) (P<0.05). The plasma level of IL-6 in MM patients with high CD117 expression was higher than that in the CD56 low expression group, but there was no statistically difference (P>0.05). The plasma level of IL-6 in MM patients was significantly decreased after chemotherapy (P<0.05). CONCLUSION:IL-6 is significantly increased in newly diagnosed MM patients, and is associated with the CD56 expression of abnormal plasma cells, which could provide important auxiliary effect on diagnosis of MM; at the same time, it is significantly decreased after chemotherapy, which may be suitable as a monitoring indicator in treatment of MM patients.

目的 探讨调节性B细胞(Breg)和TH1/TH2/TH17细胞因子在儿童手足口病(HFMD)中的作用.方法 应用流式细胞术检测93例HFMD外周血CTL细胞、NK细胞、Breg细胞和Treg细胞的表达情况,CBA方法分析血清TH1/TH2/TH17细胞因子表达水平.以41例健康儿童为对照.结果 HFMD轻重症组Breg细胞和Treg细胞的表达均显著低于照组(P＜0.01),重症组显著低于轻症组(P＜0.01);CTL细胞和NK细胞及其颗粒酶B和穿孔素表达水平显著高于对照组(P＜0.01),重症组显著高于轻症组(P＜0.01).HFMD血清IFN-γ、TNF-α、IL-6、IL-17A表达水平显著高于对照组(P＜0.01),重症组IFN-γ、TNF-α、IL-4、IL-6、IL-10、IL-17A表达水平均显著高于轻症组,上述差异均有统计学意义(P＜0.01).相关性分析显示,Breg与Treg的表达呈正相关(r=0.55,P＜0.01);轻症组Breg、Treg与IL-10表达水平呈正相关(r值分别为0.73、0.83,P＜0.O1).结论 HFMD Breg细胞表达水平显著减低,TH1/TH2/TH17细胞因子表达水平明显改变,这些变化可能参与HFMD病情进展.

目的 探讨原因不明复发性流产患者(unexplained recurrent spontaneous abortion,URSA)外周血中CD19+ CD24highCD27+调节性B细胞(regulatory B cells,Bregs)及细胞因子与复发性流产关系.方法 采用流式细胞术(FCM)分析原因不明复发性流产患者组(URSA)、正常孕妇组(NP)、正常非孕组(NNP)外周血中CD19+ CD24high CD27+ Bregs表达比例及酶联免疫双抗体夹心法(ELISA)检测外周血中细胞因子IL-2、IFN-γ、TNF-α、IL-4、IL-6、IL-10、TGF-β水平.结果 外周血CD19+ CD24 high CD27+ Bregs表达比例URSA组明显低于NP组(P＜0.01),与NNP组比较差异无统计学意义(P＞0.05).外周血中细胞因子IL-2、IFN-γ、TNF-α水平URSA组明显高于NP组、NNP组(P＜0.05);外周血中细胞因子IL-4、IL-6、IL-10、TGF-β水平URSA组明显低于NP组(P＜0.01)、NNP组(P＜0.05).相关性分析显示,URSA组外周血CD19+ CD24high CD27+ Bregs细胞比例与IL-10水平呈正相关(r=0.56,P＜0.01),而与TGF-β水平无明显相关性(r =0.24,P＞0.05).结论 外周血中CD19+ CD24high CD27+ Bregs细胞数量及功能异常可能是导致复发性流产免疫功能紊乱的重要原因之一.

Acute myelogenous leukemia (AML) is a class of malignant tumors derived from hematopoietic stem or progenitor cells. The H2.0-like homeobox gene (HLX) encodes transcription factors that function in promoting normal hematopoietic cell proliferation and tumor immunity. The present study analyzed the effect of downregulating the HLX on cell cycle distribution and cell proliferation in AML. Moreover, the current study detected changes in the expression of genes and proteins in the Janus kinase (JAK)/STAT signaling pathway to investigate the mechanism of the action of HLX in tumor immunity in AML. HLX expression in AML cell lines was silenced using small interfering siRNA, and MTS/PMS-assay colorimetric assays were used to assess the effect of knockdown of HLX on AML cell proliferation. Flow cytometry was used to analyze changes in cell cycle distribution, while reverse transcription-quantitative PCR and western blotting were used to detect changes in the expression levels of key components of the JAK/STAT signaling pathway, such as p21-activated kinase 1 (PAK1), neuropilin 1 (NRP1), B-cell translocation gene 1 (BTG1) and STAT5. It was found that HLX was differentially expressed in AML cell lines of various subtypes, and HLX expression was higher in the AML/M3 subtype NB4 cell line compared with the control group. Knockdown of HLX in NB4 cells significantly inhibited cell proliferation and arrested cells in the G(0)/G(1) phase. Moreover, STAT5 protein expression, as well as NRP1 and PAK1 expression levels were downregulated, while BTG1 expression was upregulated when HLX was knocked out by siRNA. Collectively, the results suggested that downregulation of HLX may cause G(0)/G(1) phase arrest and inhibit the proliferation of AML cells by activating the JAK/STAT signaling pathway.

目的 探讨CD200在骨髓增生异常综合征中的表达及临床意义.方法 应用流式细胞仪检测46例对照者及150例MDS患者骨髓原始细胞上CD200的表达.对101例MDS患者骨髓细胞进行了染色体核型分析.对127例MDS患者进行跟踪随访,分析CD200阳性和CD200阴性MDS患者的预后.结果 46例对照者中,CD200表达中位数为5.0％(2.6％～18.7％),1例(2.2％)CD200阳性;150例MDS患者中,骨髓髓系原始细胞CD200表达中位数为24.9％(4.4％～86.1％),其中76例(50.7％) CD200阳性;MDS患者CD200表达中位数显著高于对照组(P＜0.05).CD200在5组MDS亚型中的阳性率差异有统计学意义(P＜0.05),其在晚期阶段MDS(RAEB-1和RAEB-2)阳性率高于早期阶段MDS (RCUD、RCMD和RARS).CD200在4个MDS IPSS危险度中的阳性率差异有统计学意义(P＜0.05),其在中高危组的阳性率高于低危组.随访4～45个月后,CD200阳性MDS患者转化成急性白血病的比例高于阴性患者(P＜0.01).CD200阳性MDS患者的病死率高于CD200阴性患者(P＜0.05).CD200在CD34+CD38亚群中的表达率高于其在CD34+CD38+亚群中的表达率(P＜0.05).结论 CD200在MDS各亚型中表达临床预后差,其在骨髓髓系原始细胞CD34+CD38-亚群中过表达可能与MDS进展相关.

OBJECTIVE To investigate the effect of corticosteroids therapy on the inflammatory response in a critically ill coronavirus disease 2019 (COVID-19) patient. METHODS A 55-year old female patient with critical ill COVID-19 was admitted in Taizhou Hospital on January 19, 2020. The patient was treated with methylprednisolone 80 mg on the 2nd day after admission. Thereafter, the dose was adjusted in a timely manner and the therapy lasted for 13 days. The peripheral lymphocyte subsets (CD3+T, CD4+ T, CD8+ T, NK cells, B cells), as well as serum levels of lymphocyte factors (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ) were dynamically monitored. RESULTS On D1 of admission, the numbers of peripheral blood CD3+ T, CD4+ T, CD8+ T, and NK cells were significantly lower than the normal range. With the improvement of the disease, the numbers of CD3+ T, CD8+ T and CD4 + T cells gradually recovered and showed a linear growth trend (linear fitting equation: Y=18.59X+109.4, P<0.05). On D2 of admission, the patient's IL-6 and IL-10 levels were significantly higher than normal values, IFN-γ was at a normal high value, and then rapidly decreased; IL-2, IL-4, and TNF-α were all in the normal range. On the D6 and D7, the IL-6 and IL-10 decreased to the normal range for the first time. On the D18, the sputum virus nucleic acid test was negative for the first time, and the fecal virus nucleic acid test was still positive; on the D20 the sputum and fecal virus nucleic acid test were both negative. On D34, the patient recovered and was discharged. At the discharge the muscle strength score of the patient was 44 and the daily life ability evaluation was 90. CONCLUSIONS In the absence of effective antiviral drugs, early use of appropriate doses of corticosteroids in critically ill patient with COVID-19 can quickly alleviate inflammatory response and improve clinical symptoms, however, it may reduce the number of T cells, and to adjust the dose in time is necessary.

目的:探讨脓毒症合并急性肾损伤(AKI)患者在经过CVVH治疗后促炎介质和单核细胞CD14+HLA-DR的表达与肾功能改善的关系.方法:对我科2016年06月～2018年06月共35例脓毒症合并AKI患者住院患者进行观察,分为肾功能改善组和未改善组,两组患者分别在CVVH治疗前和第5天、第15天抽取血,送检项目包括血肌酐、TNF-α、IL-6、外周血单核细胞CD14+HLA-DR的表达.记录患者肾功能改善及ICU死亡情况.结果:(1)CVVH治疗5 d后,肾功能改善组TNF-α水平在治疗后下降,与治疗前比较差异有统计学意义(P<0.05).与未改善组TNF-α组间比较差异有统计学意义.(2)两组患者CVVH治疗前单核细胞CD14+HLA-DR表达差异无统计学意义,治疗5 d后肾功能改善组单核细胞CD14+HLA-DR比治疗前表达增强,差异有统计学意义(P<0.05).而肾功能未改善组未显示出差异有统计学意义.结论:脓毒症AKI经过CVVH治疗后血浆TNF-α、单核细胞CD14+HLA-DR可能参与了细胞免疫调节的作用,并可能与脓毒症AKI肾功能恢复有关.

AbstractObjectivesHost immune responses are indispensable to combat the disease. We report the dynamics of peripheral immune cells, cytokines, and human leucocyte antigen‐G (HLA‐G) and its receptor expressions in a patient suffering from critical COVID‐19 pneumonia to convalescence.MethodsClinical data of the patient were collected from medical records. The expressions of HLA‐G and receptors ILT2, ILT4 and KIR2DL4 in peripheral immune cells were measured with flow cytometry.ResultsFrom critical COVID‐19 to the convalescent stage, early lymphopenia was improved (median: 0.6 × 109 L−1 vs. 0.9 × 109 L−1, P = 0.009), and an obvious fluctuation in WBC and neutrophil counts was observed. Initially, low levels of CD4+ T cells (from 120 to 528 μL−1) and CD8+ T cells (from 68 to 362 μL−1) gradually increased to normal levels. Meanwhile, high IL‐6 (from 251.8 to 6.32 pg mL−1), IL‐10 (from 39.53 to 5.21 pg mL−1) and IFN‐γ (from 13.55 to 3.16 pg mL−1) levels decreased, and IL‐4 (from 2.36 to 3.19 pg mL−1) and TNF‐α (from 2.27 to 20.2 pg mL−1) levels increased quickly when the viral RNA returned negative. Moreover, the percentage of HLA‐G+ T cells, B cells and monocytes follows high–low–high pattern, while the percentage of receptors ILT2‐, ILT4‐ and KIR2DL4‐expressing cells remained relatively stable.ConclusionOur findings provide valuable information on the dynamics of early peripheral immunological responses in SARS‐CoV‐2 infection. CD4+ and CD8+ T cells, cytokines and HLA‐G+ immune cells are associated with the natural history of the critical COVID‐19 patient; however, future studies are necessary.

目的 探讨血小板膜糖蛋白CD41/CD61基因多态性及其表达率与动脉粥样硬化性急性脑梗死的关系.方法 选择动脉粥样硬化性急性脑梗死患者162例作为脑梗死组,同期健康体检者131例作为对照组,采用测序仪分析CD41/CD61基因多态性,采用流式细胞仪检测CD41和CD61表达率,采用多因素logistic回归分析发生动脉粥样硬化性急性脑梗死的危险因素.结果 两组CD41多态性基因型和等位基因频率比较差异均有统计学意义(均P＜0.05).TG+GG基因型及G等位基因与动脉粥样硬化性急性脑梗死发病风险增加有关(均P＜0.05).脑梗死组CD41表达率高于对照组,差异有统计学意义(P＜0.05),但两组CD61表达率比较差异无统计学意义(P＞0.05).脑梗死组TG+GG基因型CD41表达率高于T基因型组,差异有统计学意义(P＜0.05).多因素logistic回归分析显示高血压史、收缩压、空腹血糖、同型半胱氨酸、TG+GG基因型是发生动脉粥样硬化性急性脑梗死的危险因素(均P＜0.05).结论 CD41基因多态性TG+GG基因型影响CD41表达率,其与动脉粥样硬化性急性脑梗死发病密切相关;G等位基因是动脉粥样硬化性急性脑梗死的遗传易感基因.

OBJECTIVE:To analyze the clinical and molecular biological characteristics of a neonate with myeloid proliferation related to Down syndrome (DS).METHODS:The neonate, who was suspected for Down syndrome, was analyzed in terms of clinical feature, peripheral blood cell morphology, fluorescence in situ hybridization (FISH), immunological classification and other laboratory tests. On hundred and fourteen leukemia-related genes were subjected to next-generation sequencing (NGS).RESULTS:Laboratory test revealed obvious abnormal liver function and coagulation function, anemia, and extreme leukocytosis. Cell smear indicated significantly increased progenitor cells, which conformed to proliferation of megakaryocytes. FISH showed trisomy 21. By NGS, c.220+dupT, a novel mutation, was identified in exon 2 of the GATA1 gene, which encodes a N-terminal activation domain and has a frequency of 95.8%. No mutation was identified among the remaining 113 genes.CONCLUSION:The neonate had DS and GATA1 gene mutation. High percentage of circulating blasts should be considered as transient myelodysplasia but not congenital leukemia.

目的 探讨流式细胞术(FCM)微球芯片技术(CBA)分析TH1/TH2细胞因子谱在细菌感染中的应用价值.方法 CBA方法检测67例健康对照,111例细菌感染患者,42例非细菌感染患者TH1/TH2细胞因子表达水平,同时对比各组C反应蛋白(CRP)水平,绘制各指标的受试者工作特征(ROC)曲线并评价TH1/TH2细胞因子谱用于诊断细菌感染的价值.结果 TH1细胞因子在G+细菌感染组和G-细菌感染组表达水平略高于健康对照组.TH2部分细胞因子在G+细菌感染组和G-细菌感染组表达水平显著高于健康对照组.其中IL-6在G+细菌感染组和G-细菌感染组表达水平显著高于健康对照组(P均＜0.01),达10倍以上,IL-10在G-细菌感染组表达水平显著高于健康对照组(p＜0.01),达10倍以上.ROC曲线下面积比较,IL-6/G+细菌感染组与CRP G+细菌感染组比较差异有统计学意义(z=4.49,P＜0.01).IL-6/G-细菌感染组与CRP/G-细菌感染组比较差异有统计学意义(z=4.64,P＜0.01).IL-10/G-细菌感染组与CRP/G-细菌感染组比较,差异有统计学意义(z =4.38,P＜0.01).抗菌治疗后7天,IL-6、IL-10在细菌感染患者中的表达水平基本恢复正常,而CRP表达水平仍高于正常(P均＜0.01).结论 CBA技术分析的TH1/TH2细胞因子谱早期诊断细菌感染性能优于CRP,并能进一步辅助鉴别G+细菌和G-细菌感染及临床疗效判断.

BACKGROUND T cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematologic malignancy caused by abnormal proliferation of immature T cell progenitors. Chemotherapy of T-ALL usually consists of induction, consolidation, and long-term maintenance. Diacetyl hexamethylene diamine (CAHB) is a newly developed agent that induces the differentiation of malignant cells and deprives their clonal growth ability. Since its effect on T-ALL has not been previously determined, we evaluated its potential function in the Jurkat cell line. MATERIAL AND METHODS MTT assay was conducted to evaluate the cytotoxicity and anti-proliferative effect of CAHB. The apoptosis level of CAHB-treated Jurkat cells was evaluated using flow cytometry via staining with Annexin V/PI or cleaved-caspase-3. The alteration of mitochondrial membrane potential was determined by flow cytometry. The expression of Bax and Bcl-2 was evaluated by RT-PCR and Western blot. Western blot was also used to assess the activation of Akt. RESULTS CAHB inhibited the proliferation and promoted the apoptosis of Jurkat cells in a time- and dose-dependent manner by decreasing activation of Akt, reducing the mitochondrial membrane potential, and downregulating the Bcl-2/Bax ratio. CONCLUSIONS Our data suggest that CAHB might be regarded as a novel treatment agent for T-ALL since it can induce apoptosis and inhibit proliferation of the T-ALL cell line at a relatively low level.

目的 比较免疫组化、细胞化学及流式细胞学3种方法检测急性髓系白血病(AML)胞内MPO阳性率的差异及临床意义.方法 对90例AML患者同时进行骨髓活检组织免疫组织化学染色,细胞涂片细胞化学染色及骨髓流式细胞学分析,检测MPO表达情况.结果 3种方法联合检测,AML患者MPO总阳性率为95.5％,其中免疫组织化学、细胞化学及流式细胞学方法检测MPO阳性率分别为66.7％、93.3％及87.8％,以免疫组化方法检测MPO敏感度最低,明显低于细胞化学和流式细胞学检测方法(P均<0.05),而细胞化学与流式细胞学法比较,MPO表达率差异无统计学意义(P>0.05);AML患者中,除M7外,以M5患者MPO阳性率最低(88.9％),其中免疫组织化学法MPO的检出率最低(37.0％),明显低于细胞化学法(88.9％,P<0.05),但与流式细胞学方法比较,差异无统计学意义(P>0.05).结论 细胞化学及流式细胞术检测AML患者MPO表达的阳性率优于活检组织的免疫组化法,三者结合比单独一种更有利于AML与急性淋巴细胞白血病的鉴别诊断.

目的 探讨多发性骨髓瘤(MM)初治患者及反应性浆细胞增多症(RP)血清IL-6水平的改变及临床意义.方法 以38例初治MM及56例RP为研究对象,检测其血清IL-6水平,并与31例体检健康者(正常对照组)进行对照.对经规范治疗后的38例MM患者进行随访,根据其初始IL-6水平,将其分为高表达IL-6组和低表达IL-6组,比较两组生存曲线.结果 年龄比较,MM组较其他各组年龄更大,差异有统计学意义(P＜0.05).MM组、感染组及自身免疫性疾病组IL-6水平均明显高于正常对照组,差异有统计学意义(P＜0.05).MM组IL-6水平与感染组和自身免疫性疾病组差异无统计学意义(均P＞0.05).高表达IL-6组与低表达IL-6组生存曲线差异无明显统计学意义(Log Rank值为2.613,P=0.106).结论 MM初治患者及RP患者血清IL-6水平较正常人群均有不同程度的升高,IL-6水平与初治MM患者预后相关性不大,有待进一步研究明确.

目的 分析H2.0样同源盒基因(H2.0-like homeobox gene,HLX)在急性髓系白血病(acute myelogenous leukemia,AML)患者中的临床表达情况,探究HLX基因与AML疾病预后的关系.方法 收集56例AML患者的骨髓单个核细胞,实时荧光定量PCR (quantitative real-time polymerase chain reaction,qRT-PCR)检测HLX的表达水平,并结合预后基因进行分析.结果 在临床初发的AML患者中,HLX的表达水平高于正常人(P＜0.01),HLX表达水平与白血病组患者年龄、骨髓原始细胞数显著相关(P＜0.05),HLX表达水平与染色体核型代表的预后分层无明显关联(P＞0.05).结论 HLX基因在AML患者中的表达水平是上调的,可能拥有独立的预后信息,是AML中潜在的干预靶点.

目的 本研究旨在探讨类风湿性关节炎(rheumatoid arthritis,RA)患者外周血中NK细胞表达NKG2D、NKG2A及胞内颗粒酶B的水平,并且分析它们与疾病活动度(DAS28)的相关性.方法 流式细胞术检测41例RA患者和35例健康对照者外周血中NK细胞、NKG2D+NK细胞、NKG2A+NK细胞以及颗粒酶B+NK的表达水平;采用Spearman秩相关分析法分析它们与DAS28的相关性.结果RA患者外周血中,NK细胞表达水平显著低于健康对照组(P=0.016);NKG2D的表达水平显著低于健康对照组(P =0.002),且NKG2D的表达水平与DAS28评分呈负相关(P＜0.05);NKG2A的表达水平与健康对照组之间比较差异无统计学意义(P=0.547),且与DAS28评分不存在显著相关性(P＞0.05);颗粒酶B的表达水平有所降低(P=0.034),但与DAS28评分不存在显著相关性(P＞0.05).结论 活化性受体NKG2D以及胞内颗粒酶B表达的异常降低可能导致NK细胞杀伤活性的损伤,不能有效杀伤免疫效应细胞,从而促进了RA的发生、发展.

BACKGROUND: We studied the expression of CD200 in a series of 101 patients with diagnosis of myelodysplastic syndrome (MDS), to evaluate its impact on outcome and its possible association with other known prognostic factors.MATERIAL/METHODS: The CD200 was detected by flow cytometry, and the chromosome karyotypes were determined by G banding respectively. The Mann-Whitney U test was used to analyze the association among CD200 expression and clinical features. In addition, the overall survival and AML transformation of the MDS patients according to the expression level of CD200 was also explored.RESULTS: Overall, the flow cytometric analyses confirmed that expression of CD200 was high in this patient cohort compared to normal BM (p<0.01). The levels of CD200 in RCUD (20.3%+/- 4.3%), RCMD (25.0%+/- 4.5%), RAEB-1 (39.2%+/- 4.9%), and RAEB-2 (43.2%+/- 5.8%) groups were obviously higher than that of RARS group (6.8%+/- 1.7%, P<0.05). Significant differences of CD200 expression were observed in the 4 groups of MDS according to IPSS risk(P<0.01). After 45-month follow-up, Kaplan-Meier analysis of patients with MDS in our study indicated that patients with high expression level of CD200 had a shorter overall survival and a high Leukemic transformation than those with low expression (p<0.01).CONCLUSIONS: In conclusion, our findings provide firstly the evidence that CD200 is up-regulated and emerging as both a prognostic factor and a potential target of novel therapeutic approaches for MDS. (C) 2017 Elsevier Ltd. All rights reserved.

Both human leukocyte antigen-G (HLA-G) and myeloid-derived suppressor cells (MDSCs) was associated with the pathogenesis of infectious diseases. Whether peripheral MDSCs express HLA-G during virus infection remains unknown. We investigated the frequency of HLA-G+ MDSCs and its subsets in patients infected with chronic hepatitis B (CHB). In this study, frequencies of peripheral MDSCs (Lin1-HLA-DR-CD33+CD11b+) and HLA-G expressing subsets from 50 CHB patients and 27 normal controls were analyzed using flow cytometry. Data revealed the median percentage of MDSCs was not significantly different between the CHB patients and controls (0.30% vs. 0.29%; p=0.884). Among MDSCs, similar frequency was observed for CD14+ monocytic MDSC (mMDSCs; 31.25% vs. 23.35%; p=0.063) and CD15+ granulocytic MDSC (gMDSCs; 22.60% vs. 21.55%; p=0.558) between the two groups. However, HLA-G+ MDSCs was significantly increased in CHB patients compared with that of controls (3.30% vs. 0.50%; p<0.001). Furthermore, both HLA-G+ mMDSCs (0.99% vs. 0.00%; p<0.001) and HLAG+ gMDSC (0.78% vs. 0.00%; p<0.001) were also dramatically increased in CHB patients. Particularly, HLA-G+ gMDSC was inversely correlated to the viral DNA loads and significantly increased in HBeAb positive patients. Summary, this work reports for the first time HLA-G+ MDSCs, a new population of peripheral MDSCs, were expanded in CHB patients; however, its clinical relevance yet to be further explored.

Objective To investigate the immunological characteristics and clinical significance of reactive plasmacytosis in patients with severe fever with throbocytopenia syndrome (SFTS). Methods Bunyavirus-infected patients who were diagnosed with SFTS were collected from March 2015 to October 2015 in Taizhou Hospital. Morphology analysis of bone marrow and peripheral blood (PB) smear, as well as flow cytometry analysis of plasma cell immune phenotype from peripheral blood were conducted. Serum immunoglobulin levels and helper T hymphocytes (Th)1/Th2 cytokine expressions were detected. Mann-Whitney U test was used. Results PB plasma cells from all of the SFTS patients increased in varying degrees, and the phenotype of the plasma cells was CD19+ CD38+ + CD45+ CD138+ , which indicated normal mature plasma cells. The ratio of PB plasma cells was >0.030 in 10/16 patients, and >0.300 in 2/16 patients. The ratios of PB plasma cells in the patients with severe and critical groups were significantly higher than that in the mild group (0.052 vs 0.016, P 0.05). The serum IgG, IgA and IgM levels did not increase in acute stage, with the median of 11.6 g/L, 2.56 g/L and 1.60 g/L (reference value 0.46 to 3.04 g/L), respectively. Conclusion The patients with SFTS show excessive humoral and cellular immunity, and the severity of disease is positively correlated with the ratio of peripheral plasma cells and the levels of cytokines IL-6 and IL-10. Key words: Novel bunyavirus; Severe fever with throbocytopenia syndrome; Reactive plasmacytosis; Lymphohistiocytosis, hemophagocytic; Cell morphology; Plasma cells; Cytokines