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Functional characterization of NK cells in Mexican pediatric patients with acute lymphoblastic leukemia: Report from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia.
PLOS ONE ( IF 2.9 ) Pub Date : 2020-01-17 , DOI: 10.1371/journal.pone.0227314
Lucero Valenzuela-Vazquez 1 , Juan Carlos Núñez-Enríquez 2 , Jacqueline Sánchez-Herrera 1 , Elva Jiménez-Hernández 3 , Jorge Alfonso Martín-Trejo 4 , Laura Eugenia Espinoza-Hernández 3 , Aurora Medina-Sanson 5 , Luz Victoria Flores-Villegas 6 , José Gabriel Peñaloza-González 7 , José Refugio Torres-Nava 8 , Rosa Martha Espinosa-Elizondo 9 , Raquel Amador-Sánchez 10 , Jessica Denisse Santillán-Juárez 11 , Janet Flores-Lujano 2 , María Luisa Pérez-Saldívar 2 , Luis Ramiro García-López 12 , Alejandro Castañeda-Echevarría 13 , Francisco Rodríguez-Leyva 14 , Haydeé Rosas-Vargas 15 , Minerva Mata-Rocha 15 , David Aldebarán Duarte-Rodríguez 2 , Omar Alejandro Sepúlveda-Robles 15 , Ismael Mancilla-Herrera 16 , Juan Manuel Mejía-Aranguré 17 , Mario Ernesto Cruz-Munoz 1
Affiliation  

Acute lymphoblastic leukemia (ALL) is the most common cancer in children around the globe. Mexico City has one of the highest incidence rates of childhood leukemia worldwide with 49.5 cases per million children under the age of 15 which is similar to that reported for Hispanic populations living in the United States. In addition, it has been noted a dismal prognosis in Mexican and Hispanic ALL pediatric population. Although ALL, like cancer in general, has its origins in endogenous, exogenous, and genetic factors, several studies have shown that the immune system also plays a deterministic role in cancer development. Among various elements of the immune system, T lymphocytes and NK cells seem to dominate the immune response against leukemia. The aim of the present study was to perform a phenotypic and functional characterization of NK cells in ALL Mexican children at the moment of diagnosis and before treatment initiation. A case-control study was conducted by the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL). 41 cases were incident ALL children younger than 17 years old and residents of Mexico City. 14 controls were children without leukemia, matched by age and sex with cases. NK cell function was evaluated by degranulation assays towards K562 cells and SLAM-associated protein (SAP) expression was measured by intracellular staining. All assays were performed using peripheral blood mononuclear cells from controls and patients. The results indicate that NK mediated cytotoxicity, measured by CD107a degranulation assays in response to K562 cells, was reduced in ALL patients compared to controls. Interestingly, an impaired NK cell killing of target cells was not equally distributed among ALL patients. In contrast to patients classified as high-risk, standard-risk patients did not display a significant reduction in NK cell-mediated cytotoxicity. Moreover, patients presenting a leukocyte count ≥ 50,000xmm3 displayed a reduction in NK-cell mediated cytotoxicity and a reduction in SAP expression, indicating a positive correlation between a reduced SAP expression and an impaired NK cell-mediated citotoxicity. In the present study it was observed that unlike patients with standard-risk, NK cells from children presenting high-risk ALL, harbor an impaired cytotoxicity towards K562 at diagnosis. In addition, NK cell function was observed to be compromised in patients with a leukocyte count ≥50,000xmm3, where also it was noticed a decreased expression of SAP compared to patients with a leukocyte count <50,000xmm3. These data indicate NK cell-mediated cytotoxicity is not equally affected in ALL patients, nevertheless a positive correlation between low SAP expression and decreased NK cell-mediated cytotoxicity was observed in ALL patients with a leukocyte count ≥50,000xmm3. Finally, an abnormal NK cell-mediated cytotoxicity may represent a prognostic factor for high-risk acute lymphoblastic leukemia.

中文翻译:

墨西哥小儿急性淋巴细胞白血病患者中NK细胞的功能表征:墨西哥鉴定儿童期白血病原因的机构间小组的报告。

急性淋巴细胞白血病(ALL)是全球儿童中最常见的癌症。墨西哥城是全世界儿童白血病的最高发病率之一,每15岁以下的百万儿童中有49.5例,与居住在美国的西班牙裔人口的报道相近。另外,已经注意到墨西哥和西班牙裔ALL儿童患者的预后不良。尽管ALL与一般的癌症一样,起源于内源性,外源性和遗传因素,但多项研究表明免疫系统在癌症的发展中也起着决定性的作用。在免疫系统的各种元素中,T淋巴细胞和NK细胞似乎主导了针对白血病的免疫反应。本研究的目的是在诊断时和治疗开始前对所有墨西哥儿童中的NK细胞进行表型和功能表征。墨西哥跨机构小组进行了一项病例对照研究,以查明儿童白血病的成因(MIGICCL)。墨西哥城居民中所有17岁以下的儿童均为41例。14名对照是无白血病的儿童,按年龄和性别与病例相匹配。通过对K562细胞的脱粒试验评估NK细胞功能,并通过细胞内染色测量SLAM相关蛋白(SAP)的表达。所有测定均使用来自对照和患者的外周血单核细胞进行。结果表明NK介导的细胞毒性 与对照组相比,所有患者的CD107a脱粒试验对K562细胞的反应检测结果均降低。有趣的是,在所有患者中,靶细胞对NK细胞杀伤力的损害并不均等。与被分类为高风险的患者相反,标准风险的患者并未显示NK细胞介导的细胞毒性显着降低。此外,白细胞计数≥50,000xmm3的患者表现出NK细胞介导的细胞毒性降低和SAP表达降低,表明SAP表达降低与NK细胞介导的细胞毒性受损之间呈正相关。在本研究中,观察到与标准风险患者不同,来自表现出高风险ALL的儿童的NK细胞在诊断时对K562的细胞毒性受损。此外,观察到白细胞计数≥50,000xmm3的患者的NK细胞功能受到损害,并且还发现与白细胞计数<50,000xmm3的患者相比,SAP的表达降低。这些数据表明,在ALL患者中,NK细胞介导的细胞毒性没有受到同样的影响,但是,在白细胞计数≥50,000xmm3的ALL患者中,观察到SAP的低表达与NK细胞介导的细胞毒性降低之间呈正相关。最后,异常的NK细胞介导的细胞毒性可能代表了高危急性淋巴细胞白血病的预后因素。这些数据表明,在ALL患者中,NK细胞介导的细胞毒性没有受到同样的影响,但是,在白细胞计数≥50,000xmm3的ALL患者中,观察到SAP的低表达与NK细胞介导的细胞毒性降低之间呈正相关。最后,异常的NK细胞介导的细胞毒性可能代表了高危急性淋巴细胞白血病的预后因素。这些数据表明,在ALL患者中,NK细胞介导的细胞毒性没有受到同样的影响,但是,在白细胞计数≥50,000xmm3的ALL患者中,观察到SAP的低表达与NK细胞介导的细胞毒性降低之间呈正相关。最后,异常的NK细胞介导的细胞毒性可能代表了高危急性淋巴细胞白血病的预后因素。
更新日期:2020-01-21
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