骨髓增生异常综合征患者红细胞的天然免疫黏附功能及对自然杀伤细胞杀伤活性的影响

Erythrocyte native immune adhering function in patients with myelodysplastic syndrome and its effect on natural killer cell killing activity

目的 探讨骨髓增生异常综合征患者红细胞天然免疫黏附功能及对自然杀伤细胞（NK细胞）杀伤活性的影响.方法 选择我院骨髓增生异常综合征患者14例为试验组,20例健康人作为对照组,将2组外周血红细胞用柠檬酸钠抗凝,检测红细胞在自身血浆条件下对K562细胞的免疫黏附并计算黏附率;并用四甲基偶氮唑盐微量酶反应比色（MTT）法测定红细胞对正常NK细胞杀伤K562细胞活性的影响,并与未加红细胞时进行比较.结果 试验组红细胞使K562细胞形成了＂玫瑰花＂样结合.对照组红细胞对K562细胞的免疫黏附结合率为（15.6±6.7）%,试验组红细胞对K562细胞的免疫黏附结合率为（8.5±7.0）%,2组比较差异有统计学意义（t=3.66,P＜0.01）.不加红细胞条件下,对照组外周静脉血NK细胞杀伤K562细胞活性杀伤率为64%～75%,加入红细胞后为79%～88%;试验组不加入红细胞为45%～56%,加入红细胞后为51%～58%.加入红细胞后,2组NK红细胞对K562细胞的杀伤率均增加（P＜0.01）,且对照组高于试验组（P＜0.01）.结论 红细胞可增加NK细胞对K562细胞的杀伤率;骨髓增生异常综合征患者的红细胞对K562细胞的免疫黏附能力下降,并可减低NK细胞对K562细胞的杀伤率.

Objective To investigate the change of native immune adhering function （ENIAF） inself-plasma of patients with myelodysplastic syndrome and its effect on the killing activity of natural killer （ NK ） cells.Methods The whole blood was anticoagulated with citric acid. 5 μl precipitated red blood cells and 500 μl plasma of patients or controls were directly mixed with 750 μl quantitative K562 cells at 37℃ for 30 minutes. One K562 cell attached by one or more erythrocytes was counted as one rosette,the ratio of rosettes was calculated. Using K562 cells as target cells, the killing activity of NK cells isolated from normol persons was detected by MTT assay, the change of the killing activity was observed after adding RBCs. Results The ratio of rosettes formed by RBCs of 21 normal controls and K562 cells was （15.6 ＋6.7 ）%, and the ratio of rosetfes formed by RBCs of 16 patients and K562 cells was （8.5 ±7.0）%. The ability of ENIAF in patients with myelodysplastic syndrome was significantly lower than that in healthy individuals（ t = 3.66 ,P 〈 0. 01 ）. The killing rate of NK cells in peripheral blood of normal individuols was 64%-75% without adding RBCs, and it increased to 79%-88% after adding RBCs. The test group was 45%-56% without adding RBCs, and it increased to 51% -58% after adding RBCs. Conclusions It is concluded that the ENIAF of RBCs in patients with myelodysplastic syndrome decreases, accompanying the reduction of the killing activity of NK cells to K562 cells. To detect change of ENIAF may be helpful for the assessment of the immunological function of patients with myelodysplastic syndrome.