The Serum Levels Of Cytokine Interleukin-21 In Bone Marrow Failure Diseases And Its Significance

Objective1. Detect the interleukin 21 expression level of peripheral blood in patients with Aplastic anemia(AA) and Myelodysplastic syndrome(MDS) and analysis the significance of the changes in the IL- 21 in these diseases.2. Detect the expression level of the interleukin 21 of peripheral blood in patients with Severe aplastic anemia(SAA),non-severe aplastic anemia(NSAA), MDS bone marrow blasts and chromosomes to explore the significance.Methods1. Select the 73 cases of hospitalized patients who received the Hematology treatment from the People’s Hospital of Henan Province between June 2014 and September 2015. The AA group included 26 cases which composed of 15 males and 11 females, and the mean age was 42.5±20.9 years; The MDS group included 47 cases which composed of 23 males and 24 females, and the mean age was 48.7±14.2 years; The Healthy control group included 20 cases which composed of 10 males and 10 females, and the mean age was 45.0±19.2 years.2. The AA group, MDS group and control group were collected fasting peripheral blood 3ml, which anticoagulanted by heparin tubes and centrifuged supernatant to identify the expression of IL-21 and compare the different groups.3. The data using Graphpad Prism5.0 software. Results were expressed as mean ± standard deviation. After the experimental data line test normal, if the homogeneity of variance between the two groups were compared using t test, variance arrhythmia correction using t-test. Two indicators analyzed by Pearson correlation analysis. P <0.05 was considered statistically significant.Results1. IL-21 expression levels in AA group(311.7±222.4pg/ml), MDS group(205.8±137.6pg/ml) was significantly higher than the healthy control group(138.1±79.8pg/ml), the difference was statistically significant(P=0.01、P=0.044). AA group and MDS group, AA serum IL-21 expression levels higher than MDS group(P = 0.041).2. Subgroup analyzes SAA group(382.4 ± 250.7pg / ml) interleukin-21 expression levels higher than NSAA group(198.7 ± 108.1pg / ml),(P = 0.024), less than 0.05, statistically significant.3. Subgroup analysis in MDS bone marrow blast cells and IL-21 expression was negative correlated subgroup analysis, Pearson correlation coefficient was-0.307, P <0.05; MDS subgroups chromosomes good prognosis group(225.3 ± 93.6pg / ml) with poor prognosis group(196.0 ± 94.3pg / ml) IL-21 expression levels were not statistically significant(P = 0.293); IPSS risk stratification based on the low risk group(235.4 ± 99.8pg / ml) and high-risk group(183.5 ± 79.7pg no significant difference(P = 0.054) / ml) IL-21 expression levels.Conclusions1. AA group and MDS group IL-21 expression levels were higher than normal control group. Tip IL-21 to participate in AA, MDS incidence, IL-21-mediated immune imbalances play a role in AA, MDS immune disease pathogenesis; AA group was higher than the expression of IL-21 MDS patients, suggesting that IL-21 is expected to become AA, MDS differential diagnosis indicators, but still a large prospective study sample.2. AA group SAA group IL-21 expression levels higher than NSAA group difference was statistically significant, suggesting that IL-21 to detect the expression levels of AA help determine the condition and the immune status.3. MDS group IL-21 expression levels in bone marrow blast percentage was negatively correlated, in a subgroup analysis of chromosomes good prognosis group and poor prognosis group IL-21 expression was no significant difference; based on the IPSS risk stratification in the low-risk group no group differences in the expression of IL-21, suggesting that IL-21 may be involved in the early stages of MDS, but IL-21 significance of MDS prognosis and genetic changes need further study.