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微小残留病的长期存在是神经母细胞瘤(neuroblastoma,NB)易复发的主要原因。NKT细胞是一类有效的抗NB的免疫效应细胞,但是数量少,活性低。目的:探讨NB脂类提取物对患者外周血NKT细胞是否有激活作用。设计:以诊断为依据的自身对照研究。地点和对象:实验地点为解放军总医院儿内科,对象为5例神经母细胞瘤患者,男3例,女2例;年龄1.5～7.5岁。干预:实验组用NB脂类提取物作为刺激物刺激患者的外周血NKT细胞,对照组选择生理盐水。主要观察指标:两组NKT细胞的增殖程度(T细胞增殖程度和NKT/T比例)和NKT细胞对肿瘤细胞的杀伤作用。结果:实验组和对照组增殖A值分别为0.213±0.033和0.171±0.023,NKT/T比例分别为7.39±1.48和2.18±1.50,NKT细胞毒作用为(64.3±15.2)%和(44.4±11.6)%。实验组增殖程度是对照组的1.3倍(t=2.33,P=0.048),NKT/T比例是对照组的3.3倍(t=5.53,P=0.001),NKT细胞毒作用高于对照组19.84%(t=2.36,P=0.046)。结论:NB脂类提取物可以有效激活NKT细胞。利用肿瘤自身脂类抗原诱导出有效的抗自身肿瘤免疫的研究有望找到一条有效的清除微小残留病变,减少复发的免疫治疗途径。
The long-term presence of minimal residual disease is a major cause of neuroblastoma (NB) relapse. NKT cells are a class of effective anti-NB immune effector cells, but their number is low and activity is low. Objective: To investigate whether NB lipid extract can activate NKT cells in peripheral blood of patients. Design: A self-controlled, diagnosis-based study. Location and Subjects: The experimental site was Department of Pediatrics, People’s Liberation Army General Hospital. The subjects were 5 patients with neuroblastoma. There were 3 males and 2 females, aged 1.5-7.5 years. Intervention: In the experimental group, NB lipid extract was used as an irritant to stimulate peripheral blood NKT cells in patients, and the control group was given normal saline. MAIN OUTCOME MEASURES: The proliferation of two groups of NKT cells (T cell proliferation and NKT / T ratio) and NKT cell killing of tumor cells. Results: The proliferative A values of experimental group and control group were 0.213 ± 0.033 and 0.171 ± 0.023, respectively. The ratios of NKT / T were 7.39 ± 1.48 and 2.18 ± 1.50 respectively, and the cytotoxicity of NKT was (64.3 ± 15.2)% and (44.4 ± 11.6) )%. The proliferation of experimental group was 1.3 times that of control group (t = 2.33, P = 0.048), the ratio of NKT / T was 3.3 times that of control group (t = 5.53, P = 0.001) and the cytotoxicity of NKT was 19.84% (t = 2.36, P = 0.046). Conclusion: NB lipid extract can effectively activate NKT cells. It is expected to find an effective immune therapy to induce minimal residual disease and reduce relapse by inducing effective self-tumor immunity by tumor self-lipid antigen.