骨髓增生异常综合征骨髓细胞凋亡的研究

Study on the apoptosis of bone marrow mononuclear cells in patients with myelodysplastic syndrome

目的研究骨髓增生异常综合征(MDS)患者骨髓细胞凋亡改变,以探讨MDS疾病本质。方法采用TUNEL法检测42例MDS、11例巨幼细胞贫血(MegA)、8例阵发性睡眠性血红蛋白尿症(PNH)、6例Evans综合征患者和10例正常健康对照组的新鲜骨髓单个核细胞(BMMNC)的凋亡情况。结果23例(54.8%)MDS患者BMMNC呈现凋亡过度,而MegA、PNH、Evans综合征患者与对照组比较无显著差异;且MDS患者凋亡累及粒、红、巨三系各阶段造血细胞,随病情进展,凋亡程度逐渐下降。结论MDS患者存在骨髓细胞过度凋亡,凋亡过度可能为导致MDS无效造血的机制之一,病情进展可能与异常克隆逃逸凋亡有关,抗凋亡治疗为早期MDS治疗提供了新思路。

Objective To investigate the change of apoptosis of bone marrow mononuclear cells （BMMNC） in patients with myelodysplastic syndrome （MDS）. Methods The terminaldeoxytransferase （TdT）-mediated dUTP nick end labeling （TUNEL） method was used to observe the state of apoptosis of BMMNC in 42 cases of MDS, 11 cases of megaloblastic anemia （MegA）, 8 cases of paroxysmal nocturnal bemoglobinuria（PNH）, 6 cases of Evans syndrome and IO normal subjects. Results Cell apoptosis was significantly increased in MDS patients, but there was no difference between MegA, PNH, Evans syndrome and normal subjects. The cell apoptosis was all observed in myeloid blasts, maturing myeloid cells, nucleated erythriod cells and megakaryocytes in MDS patients, Apoptosis gradually decreased with the clinical progression of MDS. Conclusion Excess apoptosis may be one of the factors resulting in ineffective belnatopoiesis in MDS. During the clinical progression of MDS may exist the apoptosis of myelodyaplastic progenitors. The anti-apoptosis therapy could be used in early MDS patients.