目的：探讨白细胞介素-1β/半胱氨酸天冬氨酸特异性蛋白酶-1(Interleukin-1β,IL-1β)/ (cysteinyl aspartate specific protease-1,caspase-1)介导的细胞焦亡在伴环状铁粒幼红细胞增多的骨髓增生异常综合征中(MDS-RS)的机制。方法：选取2020年1月-2021年7月我院收治的MDS-RS患者30例,同时选取查体中心健康查体者30例作为健康对照组,比较两组研究对象的caspase-1、IL-1β、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-a(TNF-a)、γ干扰素(IFN-γ)。MDS-RS患者按预后积分系统分为较低危组(n=18)和较高危组(n=12),较低危组给予免疫抑制剂治疗或去甲基化药物治疗,比较患者治疗前、治疗后3个月、治疗后6个月caspase-1、IL-1β、IL-2、IL-4、IL-6、IL-10、TNF-a、IFN-γ水平。结果：MDS-RS患者caspase-1、IL-1β、IL-2、IL-6、IL-10、TNF-a、IFN-γ水平高于对照组,IL-4水平低于对照组,差异有统计学意义(P<0.05)。MDS-RS患者治疗前后caspase-1、IL-1β、IL-2、IL-4、IL-6、IL-10、TNF-a、IFN-γ水平差异有统计学意义(P<0.05),随着治疗时间延长,患者caspase-1、IL-1β、IL-2、IL-6、IL-10、TNF-a、IFN-γ水平逐渐降低,IL-4水平水平逐渐升高,差异有统计学意义(P<0.05)。结论：Caspase-1 和IL-1β在MDS-RS患者血清中高表达,IL-1β/Caspase-1介导的细胞焦亡可能参与了MDS-RS的发生发展,可作为临床评价其预后的重要指标。

Objective: To explore the mechanism of Interleukin-1β(IL-1β)/ cysteinyl aspartate specific protease-1(Caspase-1)mediated cell pyrolysis in myelodysplastic syndrome with ring siderocytosis (MDS-RS). Methods: The 30 MDS-RS patients from January 2020 to July 2021, and 30 healthy patients from the physical examination center were selected as the healthy control group , caspase-1, IL-1β, interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), Interleukin-10 (IL-10), tumor necrosis factor-a (TNF-a), interferon gamma (IFN-γ) were compared between two groups. MDS-RS patients were divided into lower-risk group (n=18) and higher-risk group (n=12) according to the prognostic scoring system. The lower-risk group was treated with immunosuppressive agents or demethylation drugs. The caspase-1, IL-1β, IL-2, IL-4, IL-6, IL-10, TNF-a, IFN-γ levels of the patients before treatment , 3 months after treatment, 6 months after treatment were compared. Results: The Caspase-1, IL-1β, IL-2, IL-6, IL-10, TNF-a, IFN-γ levels in MDS-RS patients were higher than those in the control group, and IL-4 levels were lower than those in the control group (P<0.05). The levels of caspase-1, IL-1β, IL-2, IL-6, IL-10, TNF-a, IFN-γbefore treatment were higher than those after treatment, the levels ofIL-4 was lower than those after treatment(P<0.05). With the prolonged treatment time, the level of caspase-1, IL-1β, IL-2, IL-6, IL-10, TNF-a, IFN-γ gradually decreased, and the level of IL-4 gradually increased (P<0.05).Conclusions: The Caspase-1 and IL-1β are highly expressed in MDS-RS patients. IL-1β/Caspase-1 mediated pyrolysis may be involved in the occurrence and development of MDS-RS, and can be used as an important indicator for clinical evaluation of its prognosis.

细胞因子在 MDS 患者中的表达及 MDS-RS 与细胞焦亡相关性研究