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目的:探讨B细胞激活因子(BLyS)及其受体在多发性骨髓瘤(MM)发病中的作用机制。方法:用酶联免疫吸附测定法(ELISA)和实时荧光定量聚合酶链反应(RFQ-PCR),对19例MM患者和30名健康人血清BLyS含量、外周血单个核细胞(PBMCs)中BLyS及其受体mRNA含量进行检测;并比较MM患者血清BLyS含量与外周血BLyS及其受体基因表达水平和免疫球蛋白(IgG、IgA、IgM)浓度、乳酸脱氢酶(LDH)、轻链(kap、lam)的相关性。结果:MM患者血清BLyS含量[(7.95±4.93)g/L]明显高于健康对照组[(2.70±1.09)g/L,P<0.01],并与LDH浓度呈正相关性(r=0.734,P<0.001);97.4%(18/19),84.2%(16/19)的MM患者PBMCs中BLyS、BCMA mRNA表达水平较正常人明显增高,并且也与LDH的含量呈正相关;而47.32%(9/19)患者TACI mRNA表达水平降低。结论:MM患者的血清BLyS蛋白浓度和PBMCs中BLyS及其受体基因表达水平有异常改变,说明BLyS及其受体可能参与MM的发病;BLyS及其受体表达水平也许可作为预后的一个指标。
Objective: To explore the mechanism of B-cell activating factor (BLyS) and its receptor in the pathogenesis of multiple myeloma (MM). Methods: Serum BLyS levels, BLyS levels in peripheral blood mononuclear cells (PBMCs) were measured in 19 MM patients and 30 healthy controls by enzyme-linked immunosorbent assay (ELISA) and real-time fluorescent quantitative polymerase chain reaction The levels of BLyS and its receptor gene in peripheral blood and the levels of immunoglobulin (IgG, IgA, IgM), lactate dehydrogenase (LDH), light chain (kap, lam) relevance. Results: The serum BLyS level in MM patients was significantly higher than that in healthy controls [(7.95 ± 4.93) g / L vs (2.70 ± 1.09) g / L, P <0.01] P <0.001). The expression levels of BLyS and BCMA mRNA in PBMCs of 97.4% (18/19) and 84.2% (16/19) patients were significantly higher than those in normal subjects and positively correlated with the level of LDH in 47.32% 9/19) patients TACI mRNA expression levels decreased. CONCLUSIONS: The serum levels of BLyS protein and the expression of BLyS and its receptor genes in patients with MM have abnormal changes, indicating that BLyS and its receptors may be involved in the pathogenesis of MM. The expression level of BLyS and its receptors may be used as an index of prognosis .