再障患者血清GM-CSF水平及体外骨髓造血祖细胞对GM-CSF的反应

The serum level of GM-CSF and the response of CFU-GM to increasing doses GM-CSF in patients with aplastic anemia

目的：了解再生障碍性贫血（再障）患者血清粒细胞巨噬细胞集落刺激因子（ｇｒａｎｕｌｏｃｙｔｅ－ｍａｃｒｏｐｈａｇｅｃｏｌｏｎｙ－ｓｔｉｍｕｌａｔｉｎｇｆａｃｔｏｒ，ＧＭ－ＣＳＦ）水平及粒－巨噬细胞系造血祖细胞（ｃｏｌｏｎｙ－ｆｏｒｍｉｎｇｕｎｉｔｓｏｆｇｒａｎｕｌｏｃｙｔｅ－ｍａｃｒｏｐｈａｇｅ，ＣＦＵ－ＧＭ）对ＧＭ－ＣＳＦ的增殖反应特性。方法：用１２５Ｉ放射免疫分析法测定１５例再障患者血清ＧＭ－ＣＳＦ水平，并用甲基纤维素半固体集落培养技术测定了１３例再障患者在不同ＧＭ－ＣＳＦ浓度时体外ＣＦＵ－ＧＭ集落形成情况。结果：１５例再障患者血清ＧＭ－ＣＳＦ水平为１３３４８±２５８６ｎｇ／Ｌ，明显高于对照组（Ｐ＜０００５），但其骨髓ＣＦＵ－ＧＭ集落数明显少于对照组（Ｐ＜０００１），慢性再障组在高浓度ＧＭ－ＣＳＦ（１０００μｇ／Ｌ）时的ＣＦＵ－ＧＭ（均数值为３３８８克隆数／１０５有核细胞）显著多于低浓度ＧＭ－ＣＳＦ（０１μｇ／Ｌ、１０μｇ／Ｌ）时的ＣＦＵ－ＧＭ（均数值分别为５６８８、１１３８克隆数／１０５有核细胞（Ｐ＜００５），重型再障组对不同浓度（０１～１０００μｇ／Ｌ）外源ＧＭ－ＣＳＦ的ＣＦＵ－?

AIM:To explore the GM-CSF serum level and the response of CFU-GM to GM-CSF in aplastic anemia(AA).METHODS:Methylcellulose semisolid culture and 125I labeled radioimmunoassay were used.RESULTS:The GM-CSF serum levels in 15 AA patients were 13248±2586ng/L which was higher than control group,P<001,but the CFU-GM yields were strikingly decreased.The GM-CSF serum levels in AA had no significant relationship to peripheral blood neutrophil counts,P>005.A dose-dependent increase of CFU-GM was observed in control group,from 48 to 198 colonies at 0.1 and 1000 μg/L of GM-CSFThe CFU-GM of CAA patients showed a better increament at 1000 μg/L of GM-CSF(3388 mean colonies/105 cells)compared to the CFU-GM at 0.1μg/L and 10 μg/L(588 and 1138 mean colonies/105 cells),P<005.In SAA patients,increasing doses of GM-CSF had little effect on CFU-GM growth in vitro (020 and 140 mean colonies/105 cells at 0.1μg/L and 1000μg/L,respectively.P>005)CONCLUSION:Hematopoietic progenitor cells of AA had decreased proliferation potency and very poor responsiveness to GM-CSF in SAA patients.But the CFU-GM can respond at high doses of GM-CSF in CAA patients.