再生障碍性贫血T细胞受体Vβ基因表达及生血合剂对其的干预作用

Changes in T-cell Receptor Repertoire in Aplastic Anemia and Effects of Shengxue Mixture

目的 利用免疫学和分子生物学技术，着重从T细胞受体β链可变区（TCR Vβ）亚家族基因表达角度探讨再生障碍性贫血（AA）的免疫发病机制及中药复方生血合剂的治疗作用。方法 AA患者分别用生血合剂（治疗组10例）和环孢霉素（对照组10例）治疗6个月以上，采用RT-PCR、基因扫描方法检测治疗前后外周血单个核细胞TCR Vβ基因表达的变化。结果 20例AA患者Vβ24个亚家族基因谱型倾斜，寡克隆亚家族所占百分率明显增多，与健康人（10名）比较差异有显著性（P〈0．01）。30％～50％的AA患者存在Vβ2、Vβ5、Vβ6、Vβ15、Vβ16、Vβ22、Vβ23寡克隆亚家族，50％以上的患者存在Vβ8、Vβ21寡克隆亚家族。治疗后两组寡克隆亚家族均比治疗前减少（P〈0．05）。结论 多个克隆性增殖的T细胞家族参与了AA的发病过程，生血合剂可改善TCR Vβ谱型倾斜程度，降低异常T细胞克隆性增殖，从而减少异常克隆的T细胞对造血组织的免疫损伤，有利于骨髓造血功能的恢复。

Objective To explore the immune pathogenesis of aplastic anemia （AA） and the therapeutic effects of Shengxue Mixture （SM） through the gene expressions of subfamilies of T-cell receptor variable region β （TCR Vβ） using immunologic and molecular biologic technology. Methods Gene expressions of TCR Vβ subfamilies in peripheral blood mononuclear cells from 20 Ant patients were detected before and after treatment with SM using RT-PCR and gene scanning method. Results TCR Vβ gene repertoire of the 24 subfamily genes deviated in AA patients, and the oligoclonal gene expressions increased obviously compared with those in healthy people （P〈0.01）, including Vβ2, 5, 6, 15, 16, 22, and 23 were found in 30%-50% AA patients, and Vβ8, 21 were in more than 50 % patients. These oligoclonal genes reduced significantly after treatment with SM compared with those before treatment （P〈0.05）. Conclusion Multiple TCR Vβ subfamilies of clonal proliferation participate in the pathogenesis of AA. SM can rectify the deviation of TCR Vβ gene repertoire, reduce the abnormal clonal proliferation of T cells, thus to alleviate the immune injury to hematopoietic tissue, and thus to benefit the recovery of hematopoiesis of bone marrow.