论文部分内容阅读
目的探讨免疫相关性全血细胞减少症(IRP)患者骨髓中辅助性T淋巴细胞(Th)亚群数量、功能改变及在发病中的作用。方法用流式细胞术同期对照研究16例正常对照组、15例初诊IRP组、24例再生障碍性贫血(AA)组、14例骨髓增生异常综合征(MDS)组骨髓Th细胞改变情况;RT-PCR方法检测10例正常人、25例初诊IRP患者、9例AA患者、9例MDS患者未经体外刺激的骨髓单个核细胞(BMMNC)中Th1细胞的代表因子IFN-γ、IL-2和Th2细胞的代表因子IL-4、IL-10的基因表达。结果(1)骨髓中Th1细胞、Th2细胞及Th1/Th2比值正常对照组为0·42%、0·24%和1·57;初诊IRP组为0·58%、1·95%和0·31;AA组为4·42%、0·41%和21·22;MDS组为0·44%、0·84%和0·96。IRP组Th1细胞与正常对照组及MDS组无显著差异(P>0·05),显著低于AA组(P<0·01);但IRP组Th2细胞显著高于正常对照组、AA组(P<0·01),与MDS组差异未达统计学意义(P=0·054)。IRP组骨髓中Th2细胞占优势,Th1/Th2比值显著低于正常对照组、MDS组及AA组(P<0·01)。(2)与正常对照组比较,初诊IRP组Th2型细胞因子IL-4、IL-10mRNA表达明显增高(P<0·01),而Th1型细胞因子IFN-γ、IL-2mRNA表达无显著增高(P>0·05);AA组Th1型细胞因子显著增高(P<0·01),而Th2型无区别;MDS组未见细胞因子表达增高。结论IRP患者骨髓Th2细胞亚群增多,Th细胞平衡向Th2偏移,且Th2型细胞因子表达增高,细胞功能亢进,可能是IRP免疫发病环节之一,也表明IRP是一种不同于AA和MDS的全血细胞减少症。
Objective To investigate the changes of the number and function of helper T lymphocytes (Th) in the bone marrow of immunocompensated pancytopenia (IRP) patients and its role in the pathogenesis. Methods 16 cases of normal control group, 15 cases of newly diagnosed IRP group, 24 cases of aplastic anemia (AA) group and 14 cases of myelodysplastic syndrome (MDS) group were studied by flow cytometry. The expression of IFN-γ, IL-2 and Th1 in bone marrow mononuclear cells (BMMNC) from 10 normal subjects, 25 newly diagnosed IRP patients, 9 AA patients and 9 MDS patients Gene expression of IL-4 and IL-10, the representatives of Th2 cells. Results (1) The ratio of Th1 cells, Th2 cells and Th1 / Th2 ratio in bone marrow were 0 · 42%, 0 · 24% and 1 · 57 in the normal control group and 0 · 58%, 1 · 95% and 0 · 31 in the AA group, 4.42% in the AA group, and 0.41% in the AA group and 21.22 in the AA group, and 0.44% in the MDS group and 0.96% in the MDS group. Compared with normal control group and MDS group, Th1 cells in IRP group were significantly lower than those in AA group (P <0.01), but Th2 cells in IRP group were significantly higher than those in normal control group and AA group P <0.01), but no significant difference with MDS (P = 0.054). Th2 / Th2 ratio in bone marrow of IRP group was significantly lower than that in normal control group, MDS group and AA group (P <0.01). (2) Compared with the normal control group, the expression of Th2 cytokines IL-4 and IL-10mRNA in newly diagnosed IRP group was significantly increased (P <0.01), while the expression of Th1 cytokines IFN-γ and IL-2mRNA was not significantly increased (P> 0.05). The level of Th1 cytokines in AA group was significantly higher than that in Th2 group (P <0.01), while there was no difference in Th2 type. No cytokine expression was found in MDS group. Conclusion IRB patients with increased Th2 cell subsets, Th balance shift to Th2, and Th2-type cytokines increased, cell function hyperactivity may be one of the IRP immune pathogenesis, also shows that IRP is a different from the AA and MDS Pancytopenia.