Expression Of Antigen CD40,CD40L,OX40 And Their Implications In Acute Myeloid Leukemia

Objective CD40,CD40L,OX40 are costimulatory molecules that express on panimmunity cells.Their interactions stimulates B-cells,dendritic cells(DC)and monocytes to proliferate,differentiate,express costimulatory molecules and increase antigen presentation, therefore it is now thought that the interactions play a important role in immunologic process. With the development knowledge of CD40,CD40L,OX40 gene structure and function,the researchers pay more attention to the action of the molecules CD40,CD40L OX40 in the treat of leukemia.This study is to evaluate the relation between the expressions of CD40,CD40L,OX40 antigen in acute myeloid leukemia(AML)and their clinical significance and the leukemia-associated gene,in order to provide a certain evident for the future leukemia therapy.Methods We collect bone marrow samples from 46 untreated patients with newly diagnosed AML who were all diagnosed by FAB method in the blood department of the Shanxi medical university second clinical hospital and 5 healthy persons.Using FCM to detect the expression of CD40,CD40L,OX40 on mononuclear cell and the mRNA expression of Bcl-2, Bcl-xL on mononuclear cell was analyzed by RT-PCR.Combined with the clinical features of AML,the statistical evaluation was performed using the statistical software "SPSS".Analyze the relationship between the expression of CD40,CD40L,OX40 on AML leukemic cell and the clinical characteristic in AML.Results(1)In the 46 AML cases,the only positive expression of CD40 antigen was found in 9cases(17.4%);the only positive expression of CD40L antigen was found in 2 cases(4.3%);the only positive expression of OX40 antigen was found in 1 cases(2.1%);there are 7 cases(15.2%)which of the antigen expression is CD40~+CD40L~+OX40~- and 11cases(23.9%) of the expression of CD40~+CD40L~+OX40~+.But the expression of CD40~+CD40L~-OX40~+ was found in 1 case(2.1%)and there are not cases of the antigen expression is CD40~-CD40L~+OX40~+.The expression none of these antigen was found 15.So,positive expression of CD40 antigen was found in 28cases(60.9%);positive expression of CD40L antigen was found in 20 cases(43.6%);positive expression of 0X40 antigen was found in 13 cases(28.3%) (positive standard antigen expression≥0.20)(2)In the 46 AML cases,46 patients have anemic symptom,20 patients have hemorrhagic symptom,hepar autumn and breast bone tendemess in 14 patients,platelet count(≤50×109~9/L) in 22 patients,19 cases have splenauxe symptom,14 cases have high leukocyte.(3)Due to the case of expression OX40 antigen patient group,single expression CD40L antigen patient group,expression CD40~-CD40L~+OX40~+ patient group,expression CD40~+CD40L~-OX40~+ patient group are small patients,so remove the data when group comparison, the left four group are the only expression CD40 antigen group①,the expression CD40~+CD40L~+OX40~- group②,the expression three antigen group③,the expression none of antigen group④.The comparison results of four group show in high leukocyte symptom patients the four group generally have differ(p＜0.001),group②incidence obviously higher than group①(22.2%)group③(9.1%),group④(26.7%)(χ~2=9.679,χ~2=14.318,χ~2=10.267).in thrombocytopenic group,four group have differ(P=0.001).group①incidence(100%)obviously higher than④group(33.3%),③group(36.4%),②group(28.6%)(χ~2=10.286,χ~2=8.811,χ~2=9.351).in splenauxe group the four group generally have differ(P=0.002).group④incidence (6.7%)obviously lower than①group(66.7%),②group(71.4%),③group(54.5%)(χ~2=9.802,χ~2=10.092,χ~2=7.394).(4)23 cases expression high Bcl-2 gene(0.617±0.096)in 46 AML patiens.20 cases high expression Bcl-XLgene(0.498±0.067)(Bcl-2≥0.60)and Bcl-xL≥0.50.All healthy persons do not express two genes.(5)①,②,③and④group and group comparison results show:the expression ofBcl-2,Bcl-xL of group①and④lower than②,③group.Collusions The expression of CD40,CD40L,OX40 antigen might be associated with some clinical features of AML and with the expression of leukemia related gene:Bcl-2,Bcl-xL. The expression of CD40 may stimulate the expression of CD40L and the expression of CD40 and CD40L may stimulate the expression of OX40.At the same time,the expression of CD40 might be associated with the expression of the leukemia-associated gene mRNA.The expression of OX40 antigen might be associated with the leukemia-associated gene Bcl-xL Bcl-2.The expression of CD40,CD40L,OX40 may be increase the possibility of suffering splenauxe,this is related with stimulate immunereaction.The single expression CD40 can lead to heavier low thrombocytic,other researchers think this is related with accompany expression of CD30L.Together with expression of CD40L can lead to lower incidence of low platelet.This shows that CD40L play a certain role in protecting.When only expression CD40 and CD40L high leukocyte incidence is above the other group,this illustrates the interaction of CD40 and CD40L can stimulate proliferate leukocyte which can raise expression of Bcl-2 and Bcl-xL.The function of OX40 is protecting,this can counteract the interaction of CD40 and CD40L and counteract the proliferate leukocyte,but it not affects the expression of Bcl-2 and Bcl-xL,maybe have other protection mechanism...