血复生浸膏对重型再生障碍性贫血患者骨髓T细胞表面CD28和CTLA4表达的影响

Effect of Xuefusheng Extract on the Expression of CD28 and CTLA4 on the Surface of T Lymphocytes of Bone Marrow in Severe Aplastic Anemia

目的:研究血复生对再生障碍性贫血(aplastic anemia,AA)患者骨髓T细胞表面分化决定簇28(cluster of differentiation 28,CD28)和(或)细胞毒T细胞相关抗原4(cytotoxic T cell antigen 4,CTLA4)表达的影响,探讨血复生治疗AA的作用机制。方法:将2006年6月至2008年6月江苏省中医院血液科门诊及住院的30例重型AA患者随机分为两组,治疗组使用血复生加环孢菌素治疗,对照组单用环孢菌素治疗。10名自愿者骨髓为正常对照组。观察时间为3个月,双色免疫荧光法测定治疗组及对照组治疗前后及正常对照组骨髓T细胞表面CD28、CTLA4表达的变化。结果:AA患者治疗前CD28的水平较正常人显著升高,差异有显著性(P<0.05),CTLA4水平有所上升,但差异无显著性(P>0.05)。治疗组及对照组CD28水平较用药前显著下降(P<0.05),治疗组较对照组下降更显著(P<0.05)。结论:血复生可增强环孢菌素的免疫调节作用,对AA的治疗起到增效作用。

Objective： To investigate the effect of Chinese medicine, Xufusheng Extract on the expres- sion of cluster of differentiation 28 （CD28） and cytotoxic T cell antigen 4 （CTLA4） on the surface of T lymphocytes of bone marrow in severe aplastic anemia （AA）, and explore the possible mechanism of Xufusheng Extract in the treatment of AA. Methods： Thirty inpatients or outpatients with severe AA, who visited Jiangsu province hospital of Chinese medicine from June 2006 to June 2008, were randomly divided into two groups： treatment group and control group. And another ten normal volunteers were selected as normal group. Treatment group were given Xuefusheng Extract and Cyclosporin A （CsA）, while control group were given CsA only. The treatment lasted for three months. The levels of CD28 and CTLA4 of bone marrow T lymphocytes were analyzed by the method of two color flow cytometry. Results： The expression of CD28 and CTLA4 in severe AA patients before treatment were significantly elevated compared with that of normal groups （P〈0.05）, and the levels of CTLA4 in the patients were also higher than those of normal group with no statistical significance （P〈0.05）. After treatment, the levels of CD28 in treatment group and control group were significantly decreased compared with those before treatment （P〈 0.05）. After treatment, the changes of CD28 in treatment group were significantly different from those in control group （P〈0.05）. Conclusion： Xuefusheng Extract can enhance the immunoregulation effects of CsA and has synergistic effect in treating AA.