再生障碍性贫血患者淋巴细胞表型变化.docVIP

再生障碍性贫血患者淋巴细胞表型变化 　　【摘要】 目的 研究再生障碍性贫血(AA)患者骨髓(BM)及外周血(PB)淋巴细胞及其活化相关分子的表达及临床意义。方法 采用双色免疫荧光标记、流式细胞仪分析AA患者的BM和PB中淋巴细胞膜分子表达。结果 AA患者BM和BP中CD8?+细胞增加,CD4/CD8比例下降,BM中CD25?+细胞和HLA-DR?+细胞增多,急性AA增加尤为显著(p(0.01),BM中CD16?+或CD56?+细胞也明显增多(P0.05);双标记分析提示T细胞主要为CD8?+细胞;急性AA患者CD8?+-CD25?+细胞显著增多(P0.01),AA患者BM中淋巴细胞活化相关分子表达增多,尤其是4-1BB?+、CD95L?+和CD40L?+细胞显著增多(P0.01)。结论 AA患者BM中淋巴细胞活化相关膜分子增多,是AA免疫功能异常及最终导致造血功能衰竭的原因之一。 　　【关键词】再生障碍性贫血;淋巴细胞异常活化;细胞表达 　　 　　The changes oflymphocytein aplastic anemia patients 　　 　　XU Xue-xin. NanyangCentralHospisal of Nanyang,HeNan473009,China 　　 　　【Abstract】 Objective To investigate the phenotypesandexpression of activated T cell membrancmolecules onlymphocytes in thePeriperal blood(PB)and bonemarrow(BM)of the patients withaplastic anemia.Methods Single and double-color immunofluorescents wereused to analyze the mononuclear cells from PB and BM of the AA patientsby flowcytometry.Results The expression of CD8?+increased and the ratio of CD4?+/CD8?+cell decreased significantly.The expression of CD25?+andHLA-DR?+was increased in the BM,whichwasmoresignificantin patientswithseriousAA(P0.01) andtheCD16?+orCD56?+positivecellsalsoincreasedonBM.Double-coloranalysisshowedthatthe most activated T cells wereCD8?+cells.the CD8?+-CD25?+lymphocytes increased significantly in the BM(P0.01).Co-stimulatorymolecules which essential to activation of lymphocytes 　　? 　　DOI:10.3760/cma.j.issn 1673-8799.2010.06.27 　　作者单位:473009河南省南阳市中心医院输血科 　　 　　such as 4-1BB?+,CD95L?+and CD40L+increased sigenficantly in the BM of AA patients.Conclusion Theincrease of co-stimulating molecules which was necessary for lymphocytes activation in the BM Of AA patients is one of main reasons to explainabnormalT cells activation and failure of hematopoiesis. 　　【Key words】Aplastlc anemial;Abnormal lymphocyte activation;Cell expression 　　 　　再生障碍性贫血(AA)是造血系统的常见疾病。据报道患者造血功能衰竭与细胞免疫功能异常、大量富克隆淋巴细胞局部浸润、多种细胞因子分泌失调等有关[1]。现已证实,淋巴细胞活化需要抗原的刺激为其活化提供第1信号,而活化第2信号则是淋巴细胞最终能否完成活化,并进行细胞增殖的关键,如无第2信号,淋巴细胞将进入免疫耐受或细胞凋亡,只有获得第2信号使细胞活化