| Background: Multiple myeloma (MM) is a plasma cell cancer deriving from malignant B-cell clone, characterized by the proliferation and the accumulation of plasma cells in bone marrow, and the production of monoclonal immunoglobulin or its fragments (M protein), with clinical performance such as a wide range of osteolytic disease or osteoporosis and anemia, infection and kidney damage. As the other tumors.many factors involving in surviaval,proliferation and apoptosis of multiple myeloma cells in the development of the disease.Recently, B-cell activation factor (BAFF) and proliferation-inducing ligand (APRIL) are found to be new members of tumor necrosis factor family and both of them have a high degree of homology. They can promote B-cells proliferation and survival, maintain the proliferation of B cells in germinal center, promote memory B cells differentiated into plasma cells and extend the life of plasma cells. BAFF and APRIL can promote the occurrence and development of a variety of B-cell tumors, including B-CLL, NHL, and so on. MM is a malignancy derived from the former B-cells. Therefore, BAFF and APRIL may be playing an important role in the incidence,development and prognosis of MM.In this study, we observe the expression of BAFF and APRIL on MM patients and explore the relationship between the BAFF and APRIL expressions and clinical tumor burden indicators of MM.Objective: (1) To determine the expression of BAFF and APRIL on bone marrow mononuclear cells (MNCs) in MM patients on gene level;(2)To determine the expression of BAFF and APRIL on serum in MM patients on protein levels; (3) To analysis the relationship between expressions of BAFF and APRIL and clinical tumor burden indicators of MM and to explore its clinical significance.Methods: Bone marrow MNCs and plasma of 25 patients of MM and 10 normal controls were collected. The mRNA expressions of BAFF and APRIL on bone marrow MNCs were detected by real-time quantitative PCR and the expressions of them in serum were tested by ELISA. BAFF and APRIL genes and proteins expression of KM3 also detected with the same methods. Results: (1) Compared with normal control,BAFF and APRIL genes levels are all quite higher in newly diagnosed group,remission group,non-remission group (P<0.05);Newly diagnosed group and non-remission group express quite higher BAFF and APRIL genes than remission group(P<0.05);there is no difference between newly diagnosed group and non-remission group(P>0.05).(2)There is no difference of BAFF gene expression among different phases of MM(P>0.05);Compared with phase II and phase I + II ,APRIL genes level is quite higher in phase III (P<0.05).(3)Compared with normal control,BAFF and APRIL concentrations in plasma are also quite higher in newly diagnosed group and non-remission group(P<0.01);There is no difference between newly diagnosed group and non-remission group,normal control and remission group.(4)BAFF concentration in plasma in phase IIIis quite higher than phase I + II (P<0.05);There is no difference APRIL concentration among different phases of MM. (5)APRIL protein level negatively correlated with ALB (P=0.049 ), positively correlated withβ2-microglobulin(β2-MG) (P=0.001),immunoglobulin(P=0.006) and percent of plasma in bone marrow (P=0.001) ; BAFF protein level negatively correlated with ALB (P=0.002) and A\G (P=0.018) .positively correlated withβ2-microglobulin (P=0.038),immunoglobulin(P=0.042),urinary bene-jones protein(P=0.001) and percent of plasma in bone marrow (P=0.001) ;BAFF and APRIL protein levels are positively correlation between themselves. (P=0.004)Conclusion: BAFF and APRIL genes and proteins expression in newly diagnosed group and non-remission group were higher than normal control and remission group;the more clinical phase the more BAFF and APRIL expression. The expression levels of BAFF and APRIL were positively correlated with the tumor load, indicating that both of them could be a new prognosis indicator of MM.
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