H22 cells. IL-22R1, the critical member of IL-22 receptor complex, was not detected in normal immune cells [32]. Notwithstanding, recent study found aberrant expression of IL-22R1 on anaplastic lymphoma kinase positiveTh22 and Th17 Cells in Different Stages of MDSanaplastic large cell lymphoma (ALK+ ALCL) cell lines [14]. Several reports have identified that IL-22 secreted by Th22 cells interacts with CD4+ T cells, monocyte-derived human macrophages and bone marrow-derived dendritic cells (DCs) [33,34,35]. To some instances, we hypothesize that Th22 cells participate in the immune regulation of hematopoiesis probably through interaction with DCs or other Th subsets. Despite these appearant correlations, at this period we cannot confirm the direct effect of Th22 on the impaired immune surveillance of L-MDS. Numerous evidences suggest Th1 cells have been linked to the development of get Octapressin autoimmune inflammatory processes. To further investigate the role of Th1 cells in the pathogenesis of MDS, we also examined the percentages of periphery Th1 cells in MDS patients and healthy donors. In contrast to the results of periphery Th22 and Th17 cells, no statistical difference was shown in Th1 frequencies between patients with MDS and healthy donors. Although previous studies showed that the conventional Th1prototypical cytokines IFN-c and TNF-a were predominant in MDS, it was later confirmed that these cytokines were derived from macrophage lineage cells [36]. Meanwhile, statistical correlations between Th1 cells and Th22 cells or Th17 cells were not found in this study. IL-22 has been involved in the pathophysiology of some malignant diseases, such as multiple myeloma [37]. As to MDS, the expression level of IL-22 has not been investigated until today. Our results demonstrated for the first time that the level of IL-22 either in BM or in PB of MDS patients was comparable with that of 1531364 healthy controls, and no correlation with peripheral Th22 cells was revealed. IL-22 is not exclusively produced by Th22 cells, but 94361-06-5 rather appears to be produced by other T cells such as CD4+IL17+IL-22+ cells and CD4+IFNc+IL-22+ cells, as well as circulating NK cells [38,39]. The frequency of Th22 cells among total IL-22producing T cells ranges from 37 to 63 [9]. When taking IL22-producing NK cells into account, that proportion will become smaller. In MDS, groups have reported that function of MDS-NKcells are reduced and cytokine secretion are decreased [40]. The data above unambiguously indicate that the unilateral increased frequency of Th22 cells contributes little to the IL-22 production capacity. On the other hand, mounting evidences support that IL6 possesses a developmental relationship to the IL-22 production [24]. Inversely, TGF-b down-regulates the IL-22 production [41]. Compelling evidence has been achieved from several groups that levels of IL-6 as well as TGF-b are increased in MDS patients [42,43]. So the unaltered extracellular level of IL-22 can be partially attributed to the regulating homeostasis between IL-6 stimulative and TGF-b inhibitory effect. In summary, for the first time we showed a clear difference between E- and L-MDS in terms of Th22-cell related immunological environment. Circulating Th22 expansion occurs much more frequently in late stage, which may favor the escape of the preleukemic clone. By contrast, in early stage, circulating Th17 expansion tends to be predominant, thereby underpinning the inflammatory autoimmune assault and eventu.H22 cells. IL-22R1, the critical member of IL-22 receptor complex, was not detected in normal immune cells [32]. Notwithstanding, recent study found aberrant expression of IL-22R1 on anaplastic lymphoma kinase positiveTh22 and Th17 Cells in Different Stages of MDSanaplastic large cell lymphoma (ALK+ ALCL) cell lines [14]. Several reports have identified that IL-22 secreted by Th22 cells interacts with CD4+ T cells, monocyte-derived human macrophages and bone marrow-derived dendritic cells (DCs) [33,34,35]. To some instances, we hypothesize that Th22 cells participate in the immune regulation of hematopoiesis probably through interaction with DCs or other Th subsets. Despite these appearant correlations, at this period we cannot confirm the direct effect of Th22 on the impaired immune surveillance of L-MDS. Numerous evidences suggest Th1 cells have been linked to the development of autoimmune inflammatory processes. To further investigate the role of Th1 cells in the pathogenesis of MDS, we also examined the percentages of periphery Th1 cells in MDS patients and healthy donors. In contrast to the results of periphery Th22 and Th17 cells, no statistical difference was shown in Th1 frequencies between patients with MDS and healthy donors. Although previous studies showed that the conventional Th1prototypical cytokines IFN-c and TNF-a were predominant in MDS, it was later confirmed that these cytokines were derived from macrophage lineage cells [36]. Meanwhile, statistical correlations between Th1 cells and Th22 cells or Th17 cells were not found in this study. IL-22 has been involved in the pathophysiology of some malignant diseases, such as multiple myeloma [37]. As to MDS, the expression level of IL-22 has not been investigated until today. Our results demonstrated for the first time that the level of IL-22 either in BM or in PB of MDS patients was comparable with that of 1531364 healthy controls, and no correlation with peripheral Th22 cells was revealed. IL-22 is not exclusively produced by Th22 cells, but rather appears to be produced by other T cells such as CD4+IL17+IL-22+ cells and CD4+IFNc+IL-22+ cells, as well as circulating NK cells [38,39]. The frequency of Th22 cells among total IL-22producing T cells ranges from 37 to 63 [9]. When taking IL22-producing NK cells into account, that proportion will become smaller. In MDS, groups have reported that function of MDS-NKcells are reduced and cytokine secretion are decreased [40]. The data above unambiguously indicate that the unilateral increased frequency of Th22 cells contributes little to the IL-22 production capacity. On the other hand, mounting evidences support that IL6 possesses a developmental relationship to the IL-22 production [24]. Inversely, TGF-b down-regulates the IL-22 production [41]. Compelling evidence has been achieved from several groups that levels of IL-6 as well as TGF-b are increased in MDS patients [42,43]. So the unaltered extracellular level of IL-22 can be partially attributed to the regulating homeostasis between IL-6 stimulative and TGF-b inhibitory effect. In summary, for the first time we showed a clear difference between E- and L-MDS in terms of Th22-cell related immunological environment. Circulating Th22 expansion occurs much more frequently in late stage, which may favor the escape of the preleukemic clone. By contrast, in early stage, circulating Th17 expansion tends to be predominant, thereby underpinning the inflammatory autoimmune assault and eventu.
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