EFFECTS OF N'Z CYCLOSPORINE COMBINED WITH ANDROGEN ON SERUM TH1/TH2 CELLS AND RELATED CYTOKINES AND T CELL SUBSETS IN PATIENTS WITH CHRONIC APLASTIC ANEMIA

Ming Xie, Di Wu, Mengchang Wang, Pengcheng He^*

Department of Hematology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, PR China

Objective: To analyze the effects of cyclosporine combined with androgen on serum Th1/Th2 cells and related cytokines and T cell subsets in patients with chronic aplastic anemia (CAA). 

Methods: Ninety patients with chronic aplastic anemia visited the Department of Hematology in our hospital from May 20 to June 2019 and were randomly divided into the control group and the observation group, with 45 cases in each group. The control group was treated with androgen alone, and the observation group was treated with cyclosporine combined with androgen. Th1Th2 cells and related cytokines and T cell subsets were detected by enzyme-linked immunosorbent assay (ELISA) and flow cytometry. The levels of serum Th1/Th2 cells and related cytokines and T cell subsets were compared between the two groups. 

Results: After treatment, the total effective rate was 75.56% in the control group and 93.33% in the observation group. The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the ratio of Th1 in the observation group was significantly decreased compared with the Th1/Th2 ratio in the control group(p<0.01), and there was no significant difference in the Th2 ratio (P>0.05). Furthermore, the levels of Th1 cells in the observation group and the control group were significantly lower than those before treatment, and the level of Th1 cells in the observation group was lower than that in the control group. The levels of Th2 cells in the two groups were significantly higher than those before treatment, and the levels of Th2 cells in the observation group were higher than those in the control group (P<0.01). In addition, the levels of IL-4 and IFN-γ cells in the observation group and the control group were significantly lower than those before treatment, and the levels of IL-4 and IFN-γ cells in the observation group were lower than those in the control group (P<0.05). The level of CD⁸⁺ in the observation group and the control group was significantly lower than before treatment, and the CD₈⁺ level in the observation group was lower than that in the control group. The CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺ in the observation group and the control group were significantly higher than those before the treatment, and the observation group was higher than the control group (P<0.05). Finally, the incidence of adverse reactions in the control group was 11.11% after treatment, and in the observation group it was 13.33%; the difference was not statistically significant (P>0.05). 

Conclusion: Cyclosporine combined with androgen in the treatment of chronic aplastic anemia can effectively promote hematopoiesis, regulate T cell subsets and immune function, cause less adverse reactions and have a significant curative effect.