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目的：探讨白细胞介素８（ＩＬ８）及其Ａ型受体（ＩＬ８ＲＡ）的表达在全反式维甲酸（ＡＴＲＡ）诱导治疗急性早幼粒细胞白血病（ＡＰＬ）中的临床意义。方法：动态检测ＡＰＬ患者１８例ＡＴＲＡ治疗中血浆ＩＬ８水平（ＥＬＩＳＡ法），取３例骨髓单个核细胞（ＭＮＣ）加ＡＴＲＡ（１０－６ｍｍｏｌ／Ｌ）体外诱导，流式细胞仪动态检测ＭＮＣ膜ＩＬ８ＲＡ的表达。结果：ＭＮＣ加ＡＴＲＡ诱导７２小时，上清ＩＬ８水平明显下降，ＭＮＣ膜表达ＩＬ８ＲＡ增高；维甲酸综合征（ＲＡＳ）发生前血浆ＩＬ８异常升高（达１０１０～２０００ｎｇ／Ｌ），较体温及白细胞数量变化更敏感；感染时血浆ＩＬ６、ＩＬ８水平均明显升高［分别为（１１２．３４±５７．３１）×１０３Ｕ／Ｌ，２３４．１６±７２１８ｎｇ／Ｌ］；弥散性血管内凝血（ＤＩＣ）恶化时ＩＬ８与Ｄ二聚体异常同步上升。结论：ＡＴＲＡ抑制ＡＰＬ细胞分泌ＩＬ８，加强ＩＬ８ＲＡ的表达；监测ＩＬ８水平可预测ＲＡＳ及感染发生；ＩＬ８与Ｄ二聚体异常同步上升提示ＤＩＣ恶化趋势。
Objective: To investigate the clinical significance of the expression of interleukin-8 (IL-8) and its type-A receptor (IL-8RA) in all-trans retinoic acid (ATRA)-induced acute promyelocytic leukemia (APL). METHODS: Plasma levels of IL-8 in 18 APL patients undergoing ATRA therapy were measured by ELISA. Three bone marrow mononuclear cells (MNCs) plus ATRA (10-6 mmol/L) were induced in vitro. Flow cytometry was used to detect MNCs dynamically. Expression of membrane IL-8RA. RESULTS: After 72 hours of MNC plus ATRA induction, the level of IL-8 in the supernatant was significantly decreased, and the expression of IL-8RA in MNC membrane was increased. The abnormal increase of plasma IL-8 was observed before retinoid syndrome (RA-S) (up to 1010 to 2000ng/mL). L), more sensitive to changes in body temperature and leukocyte counts; plasma IL-6, IL-8 levels were significantly higher at the time of infection (112.34 ± 57.31) × 103 U / L, 234.16 ± 72 18ng/L]; Disseminated intravascular coagulation (DIC) deteriorated synchronously when IL-8 and D-dimer increased. Conclusion: ATRA inhibits the secretion of IL-8 from APL cells and enhances the expression of IL-8RA. The monitoring of IL-8 levels can predict the occurrence of RA-S and infections. The abnormal increase of IL-8 and D-dimer indicates the tendency of DIC deterioration.