T细胞克隆扩增与骨髓增生异常综合征

Clonal Expanded T-Cell Repertoire in MDS——Review

骨髓增生异常综合征(MDS)是一组异质性的克隆性造血干细胞异常疾病,病人常伴有免疫学异常。T细胞介导的造血前体细胞抑制而导致细胞减少与MDS的发生发展有一定相关性。本文总结了目前基于T细胞受体(TCR)谱系等分析所研究的MDS病人T细胞克隆扩增特点,论述的主要问题包括有:MDS病人自身免疫现象和T细胞介导造血抑制的相关性,MDS病人中T细胞克隆扩增特点,MDS病人T细胞谱系变化,MDS病人胸腺近期输出功能变化,免疫抑制治疗效果与MDS病人T细胞克隆的相关性,以及T细胞克隆分析的临床应用价值等。

The myelodysplastic syndromes （MDS） comprises a heterogeneous group of clonal hematopoietic stem cell disorders, while immunological abnormalities are frequently observed in such patients. T-cell mediated suppression of hematopoietic precursors contributes to the cytopenia and is related to the initiation and development of myelodysplastic syndromes （MDS）. In this review, current knowledge concerning the feature of T-cell clonal expansion in MDS based on the analysis of T-cell receptor repertoire is summarized, including following issues： autoimmunity in MDS patients associated with T-cell mediated suppression of hematopoiesis, characteristics of T-ceU clonal expansion in MDS patients, change of T-cell repertoier and recent thymus output function in MDS patients, efficiency of immunosuppressive treatment associated with T- cell clonal expansion in MDS patients and significance of T-cell clonal analysis in clinical application.