Table 1.
Demographic and clinical characteristics of MDS patients.
Figure 1.
Circulating percentages of Th17, Th1 and Th22 cells in representative healthy controls, E-MDS and L-MDS patients.
Heparinized peripheral whole blood from 37 MDS(E-MDS, n = 17; L-MDS, n = 20)patients and 20 healthy PB donors were stimulated with phorbol myristate acetate, ionomycin, and monensin for 4 h, and then stained with labeled antibodies for FACS analysis. (A) Lymphocytes were gated by flow cytometry. (B, C, D) Representative FACS dot plots of circulating Th17 (CD4+IL-17+) cells from healthy controls, E-MDS and L-MDS patients. (E, F, G) Representative FACS dot plots of circulating Th1 (CD4+IFNγ+) cells from healthy controls, E-MDS and L-MDS patients. (H, I, J) Representative FACS dot plots of circulating Th22 (CD4+IL-22+IL-17−IFNγ− ) cells from healthy controls, E-MDS and L-MDS patients. Numbers in plots indicate relative percentages per quadrant.
Figure 2.
Circulating percentages of Th17 cells, Th1 cells, and Th22 cells in MDS.
(A) Circulating percentages of Th17 (CD4+ IL-17+) cells from healthy controls, E-MDS and L-MDS. Significantly increased percentage of Th17 cells was found in E-MDS patients (median, 1.90%; range, 0.58–6.01%) compared to L-MDS (median, 1.16%; range, 0.15–1.86%) (*P = 0.002) or healthy controls (median, 1.01%; range, 0.55–1.69%) (*P = 0.002). (B) Circulating percentages of Th1 (CD4+IFNγ+) cells from healthy controls, E-MDS and L-MDS. There was no significant difference between E-MDS (median, 9.65%; range, 6.16–21.08%) patients and L-MDS (median, 8.41%; range, 2.59–15.23%) or healthy controls (median, 9.06%; range, 6.01–14.02%). (C) Circulating percentages of Th22 (CD4+ IL-22+ IL-17−IFNγ− ) cells from healthy controls, E-MDS and L-MDS. Significantly elevated percentage of Th22 cells was found in L-MDS patients (1.77±0.84%) compared to E-MDS (1.27±0.50%) (*P = 0.03) and healthy controls (0.71±0.17%) (*P<0.0001). Obviously increased percentage of Th22 cells was shown between E-MDS and healthy controls (*P = 0.002). (D) Circulating percentages of Th17 cells from healthy controls, bone marrow (BM) blasts <5% and blasts ≥5% patients. The circulating percentages of Th17 cells remained significantly higher in blasts <5% compared with healthy donors. (*P = 0.003).
Figure 3.
Concentrations of IL-22 and IL-17 in PB and BM from healthy controls and MDS patients.
(A) Concentrations of IL-22 in PB plasma from healthy controls, E-MDS and L-MDS patients. There was no significant difference between E-MDS (median, 21.66 pg/ml; range, 16.02–36.00 pg/ml, P>0.05) or L-MDS patients (median, 23.37 pg/ml; range, 17.00–54.66 pg/ml, P>0.05) and healthy controls (median, 23.86 pg/ml; range, 14.04–36.49 pg/ml, P>0.05). (B) Concentrations of IL-17 in PB plasma from healthy controls, E-MDS and L-MDS patients. No significant difference was found between E-MDS (median, 22.32 pg/ml; range, 19.13–50.11 pg/ml, P>0.05) or L-MDS (median, 25.39 pg/ml; range, 17.86–46.31 pg/ml, P>0.05) patients and healthy controls (median, 25.11 pg/ml; range, 16.87–37.00 pg/ml, P>0.05).(C)Concentrations of IL-22 in BM plasm from healthy controls, E-MDS and L-MDS patients. There was no significant difference between E-MDS (median, 40.34 pg/ml; range, 11.08–101.33 pg/ml, P>0.05) or L-MDS patients (median, 30.68 pg/ml; range, 23.86–49.43 pg/ml, P>0.05) and healthy controls (median, 33.59 pg/ml; range, 20.93–61.74 pg/ml, P>0.05). (D) Concentrations of IL-17 in BM plasm from healthy controls, E-MDS and L-MDS patients. No significant difference was found between E-MDS (median, 25.68 pg/ml; range, 20.96–83.13 pg/ml, P>0.05) or L-MDS patients (median, 23.48 pg/ml; range, 20.49–31.80 pg/ml, P>0.05) and healthy controls (median, 31.99 pg/ml; range, 25.11–66.37 pg/ml, P>0.05).
Figure 4.
The ratio of RORC, IL-6, TNF-α, IL-23 mRNA in healthy controls and MDS patients.
(A) The ratio of RORC mRNA in E-MDS patients compared with that of healthy controls or L-MDS was 4.7 (*P = 0.0007) or 3.3 (*P = 0.002), respectively. (B) The ratio of IL-6 mRNA in L-MDS patients compared with that of healthy controls or E-MDS was 5.3 (*P = 0.0001) or 2.4 (*P = 0.037), respectively. (C) The ratio of TNF-α mRNA in L-MDS patients compared with that of healthy controls or E-MDS was 10.6 (*P = 0.002) or 3.5 (*P = 0.049), respectively. (D) IL-23p19 mRNA expression level among E-MDS, L-MDS and healthy controls was comparable (P>0.05). Bars represent SD.