The Proportion Of Th9 And Th17 Cells And Expression Of PD-1 In Myelodysplastic Syndromes And Their Clinical Significance

Objective:By detecting the proportion of Th9 cells,Th17 cells,levels of related cytokines and expression of programmed cell death protein 1 in newly diagnosed patients with MDS,the correlated analysis of data was conducted to explore the changes of expression levels of Th9,Th17 cells,PD-1 and related cytokines in MDS as well as their clinical significance.Methods:A total of 26 patients newly diagnosed with MDS were divided into two groups(15 with low risk and 11 with high risk)and 15 normal control patients were enrolled from the Second Hospital of Lanzhou University from March 2019 to December 2020.The proportion of Th9 and Th17 cells in peripheral blood and the expression level of PD-1 on Th9,Th17 and Treg were detected by means of flow cytometry.The levels of serum cytokine interleukin-9(IL-9),interleukin-17(IL-17),interleukin-10(IL-10)and transforming growth factor-β (TGF-β )were detected through ELISA method.Results:In the high-risk MDS group,the proportion of Th9 cells(3.04±0.43%)was higher than that in low-risk group(2.30±0.27%)and the normal control group(0.74±0.35%),P<0.05;The proportion of Th17 cells(1.21±0.48%)was lower than that both in low-risk group(4.57±0.49%)and normal control group(2.45±0.67%),P<0.05;Compared with the low-risk control group and the normal control group,the proportion of Th9 cells and Th17 cells increased in the former(2.30±0.27%vs 0.74±0.35%,4.57±0.49%vs 2.45±0.67%,P<0.05).Compared with the high-risk control group and the normal control group,the level of PD-1 on Th9,Th17and Treg cells were significantly increased in the former(13.85±1.07%vs 4.57±0.85%,9.93±1.89%vs 4.85±1.64%,17.72±1.16%vs 5.25±1.18%,P<0.001).Compared with the high-risk group and the low-risk group,the expressions of PD-1~+Th9,PD-1~+Th17 and PD-1~+Treg increased significantly(13.85±1.07%vs 10.61±1.55%,9.93±1.89%vs 6.88±1.45%,P<0.05,17.72±1.16%vs 14.30±1.33%,P<0.001).Compared with the low-risk group and the normal control group,expression levels of PD-1 on Th9,Th17 and Treg were significantly increased in the former group(P<0.05,P<0.05,P<0.001).In contrast,levels of IL-9,IL-10,TGF-β in high-risk group were higher than those in the low-risk group and the normal control group(P<0.05),levels of IL-17 in high-risk group was lower than these of the latter groups(P<0.05).Compared with the low-risk control group and the normal control group,levels of cytokine IL-9,IL-10 and TGF-β increased(P<0.05),no significant difference in IL-17 levels(P=0.10).Expressions of PD-1 on Treg cells of patients with MDS were positively correlated with IL-10,TGF-β ,and negatively correlated with IL-17,expressions of PD-1 on Th17 cells were negatively correlated with IL-17,expressions of PD-1 on Th9 cells were positively correlated with TGF-β .Conclusion:1.The abnormal expression of Th9/IL-9 and Th17/IL-17 in patients with MDS may be involved in the pathogenesis of MDS.2.The increased levels of PD-1 on Th9,Th17 and Treg cells was positively correlated with diseased risk stratification,suggesting that PD-1 is expected to become a stratified and prognostic indicator of MDS.3.Levels of cytokine IL-9,IL-10,TGF-β in high-risk MDS increased,levels of cytokine IL-17 in low-risk MDS increased,and these have the close correlation with expression levels of PD-1,indicating immune abnormalities exist in different risk stratification of MDS,further research should be continued to do.