巨噬细胞在免疫相关性血细胞减少综合征中的造血损伤作用.docVIP

The immune mechanism and clinical significance of macrophage to medullary hematopoietic injury of immune-related hematocytopenia patients SUN Li-Fei, HAN Bing, WU Qiang-Qiang, ZHANG Xiao-Xi, DU Yan-Hui, WANG Gui-Chen, ZHANG Jin-Biao and ZHANG Yan Department of Tumor Research and Treatment Centricity, Peoples Liberation Army No. 148 Hospital, ZiBo 255300, ShanDong Province, China Correspondence to: Sun Li-Fei Department of Tumor Research and Treatment Centricity, Peoples Liberation Army No. 148 Hospital, ZiBo 255300, ShanDong Province, China, Email: sunlifei_2007@163.com, Tel: +86 0533-6552587 [Key words] macrophage (Mφ); immune-related hemocytopenia (IRH); ADCC effect; FcγⅡR; ICAM-1; IFN-γ; IL-17A [Abstract] Background: Observe the levels of various cytokines in the blood serum and the in situ active state of macrophage (Mφ) in the medullary hematopoietic microenvironment of immune-related hematocytopenia IRH patients, and probe into the immune mechanism and clinical significance of Mφ in hematopoietic cell injury. Methods: ELISA assay is used to detect the IL-4, IL-6, IL-12, IL-17 and IFN-γ levels in the peripheral blood serum of 376 patients in pretherapy and posttherapy, Cytochemistry and cell immunochemistry methods are used to observe the peroxydase (POX), nonspecific esterase (NSE), hemosiderin granules and HLA-DR activity of Mφ in bone marrow of patients; Immunofluorescence is used to observe the expression of hemocyte antihumanglobulin IgG antibody, lymphocytes CD4 molecule, Mφ membrane FcγⅡreceptor (FcγⅡR), mannitose receptor (MR), IFN-γ, ICAM-1, IL-12 and IL-17A and the formation mechanism of ADCC hematopoietic cell islands (HI) in the medullary hematopoietic microenvironment of patients. ④Glucocorticoid is used for treatment on the basis of anti-infection therapy, and gamma globulin stosstherapy is used for the appearance of ADCC-type hematopoietic cells (HI) or serious Mφ bloodthirsty phenomenon; if necessary, association of Cyclosporine A (CsA)