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目的 探讨沙利度胺治疗难治复发性多发性骨髓瘤 (MM)的有效机制。方法 用双抗夹心法 (ELISA)动态检测MM患者血清白细胞介素 6 (IL 6 )水平 ,流式细胞仪检测瘤细胞表面IL 6受体 (IL 6R)的表达 ,RT PCR半定量法检测IL 6Rβ亚单位mRNA的表达。 结果 口服 2 0 0mg/d沙利度胺前 ,MM患者血清IL 6水平为 5 6 4.8± 319.4ng/L ,瘤细胞表面IL 6R阳性率为 33.6 % ;口服 2 0 0mg/d沙利度胺后第 14天 ,IL 6水平为 5 6 0 .3± 414.8ng/L ,瘤细胞表面IL 6R阳性率为 31.8% ,分别与口服沙利度胺前比较 ,差异无显著性 (P >均 0 .0 5 )。口服 40 0mg/d沙利度胺第 14,2 8,42 ,5 6 ,84天 ,IL 6水平分别为 5 16 .7± 131.9、42 6 .7± 180 .4、387.9± 187.4、35 0 .1± 85 .5和 2 12 .3± 92 .5ng/L ,瘤细胞表面IL 6R阳性率分别为 2 8.5 %、2 4.3%、2 1.3%、12 .6 %和 10 .1% ,均分别低于口服 2 0 0mg/d沙利度胺前IL 6水平或瘤细胞表面IL 6R阳性率 (P <0 .0 5或P <0 .0 1) ;口服 2 0 0mg/d沙利度胺前及口服第 14天的IL Rβ亚单位mRNA比值分别为 7.8和 6 .9,二者差异无显著性 (P >0 .0 5 ) ;口服沙利度胺 40 0mg/d第 14,2 8天IL Rβ亚单位mRNA的比值分别为 5 .3和 2 .7,与口服 2 0 0mg/d沙利度胺前的比较 ,差异有显著性 (P
Objective To investigate the effective mechanism of thalidomide in refractory relapsed multiple myeloma (MM). Methods The levels of serum IL-6 in patients with MM were measured by ELISA. The expression of IL-6 receptor (IL-6R) was detected by flow cytometry. The levels of IL-6R 6Rβ subunit mRNA expression. Results Before oral administration of 2.0 mg / d thalidomide, the level of IL-6 in MM patients was 56.84 ± 319.4 ng / L, the positive rate of IL-6R in tumor cells was 33.6%. The oral administration of 2.0 mg / d thalidomide After 14 days, the level of IL-6 was 56.03 ± 414.8ng / L, the positive rate of IL-6R on tumor cells was 31.8%, which was not significantly different from that before oral thalidomide (P> 0.05) .0 5). On the 14th, 28th, 42nd, 56th, 84th day after oral administration of 40 mg / d thalidomide, the levels of IL 6 were 5 16.7 ± 131.9, 42 6 .7 ± 180 .4, 387.9 ± 187.4, 35 0 .1 ± 85.5 and 2 12.3 ± 92.5 ng / L respectively, the positive rates of IL-6R on tumor cells were respectively 21.5%, 23.3%, 21.3%, 12.6% and 10.1% Respectively, which were lower than the pre-thalidomide level of IL-6 or the positive rate of IL-6R on the surface of tumor cells (P <0.05 or P <0.01), respectively. Oral administration of 2.0 mg / d thalidomide The ratio of IL Rβ subunit mRNA before and 14 days after oral administration was 7.8 and 6.9, respectively, with no significant difference (P> 0.05); oral thalidomide 40 0 mg / d 14 and 2 The ratios of IL Rβ subunit mRNA on day 8 were 5.3 and 2.7, respectively, compared with those before oral administration of 2.0 mg / d thalidomide (P