Objective To investigate the changes and clinical significance of Tfh cells and their subsets in patients with chronic lymphocytic leukemia(CLL).Methods Seventy newly diagnosed CLL patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2021 to September 2023 were selected as the CLL group,with 50 healthy individuals as the control group.The proportion of Tfh,Tfh1,Tfh2 and Tfh17 cells was detected by flow cytometry,and the expression levels of PD-1 and ICOS in Tfh cells were detected.The expression levels of BCL-6,Blimp-1 and IL-21 mRNA were detected by PCR.The protein levels of BCL-6 and Blimp-1 were detected by western blot.The serum levels of cytokine IL-21 were detected by ELISA.Results The proportions of Tfh,Tfh1,PD-1+Tfh,ICOS+Tfh,and PD-111COS+Tfh cells in peripheral blood of CLL patients were significantly increased compared with healthy controls,and the subset ratio Tfh1/(Tfh2+Tfh17)ratio was also significantly increased(P＜0.05).Compared with healthy controls,BCL-6,Blimp-1,and IL-21 levels were significantly increased in the CLL patient group,and the BCL-6/Blimp-1 ratio was also significantly increased(P＜0.05).After correlation analysis,BCL-6 levels,BCL-6/Blimp-1 ratio,and IL-21 levels were positively correlated with Tfh and Tfh1/(Tfh2+Tfh17)(P＜0.05).Clinical indicator analysis revealed that higher IPI scores were associated with an increased proportion of Tfh cells and a higher Tfh1/(Tfh2+Tfh17)ratio.Additionally,these parameters were positively correlated with bone marrow B lymphocytes(P＜0.05)and negatively correlated with immunoglobulin levels(P＜0.05).Conclusion Peripheral blood Tfh cells in CLL patients are involved in disease pathogenesis,and there is a subset imbalance skewing towards Tfh1 cells.The abnormal differentiation of Tfh cells may play a role in the pathogenesis of CLL and the mechanisms underlying humoral immune dysregulation.
chronic lymphocytic leukemiafollicular helper T cellsimmune disorders
维普
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