阵发性睡眠性血红蛋白尿症患者CD34^＋CD59^-与CD34^＋CD59^-细胞膜EPO、TPO受体后STAT5磷酸化水平的关系

STAT5 phosphorylation levels of erythropoietin and thrombopoietin receptors in CD34^＋ CD59^ - and CD34^＋ CD59 ^- bone marrow cells of patients with paroxysmal nocturnal hemoglobinuria

目的观察阵发性睡眠性血红蛋白尿症（PNH）患者骨髓CD34^＋CD59 ^-和CD34^＋CD59 ^-细胞膜促红细胞生成素（EPO）受体（EPOR）、血小板生成素（TPO）受体（TPOR）后信号转导通路中信号转导和转录激活因子（STAT）5磷酸化水平。方法应用流式细胞术分别检测2010年4月至2011年2月天津医科大学总医院血液肿瘤科PNH患者23例及11名健康对照骨髓单个核细胞（BMMNC）经和不经10U／mlEPO、50U／mlTPO刺激后CD34^＋CD59-和CD34^＋CD59 ^-细胞磷酸化STAT5（P-STAT5）的平均荧光强度（MFI）。结果（1）未加入细胞因子时，PNH患者CD34^＋CD59 ^-细胞P-STAT5的MFI为31±15，明显低于CD34^＋CD59 ^-细胞（74±47，P〈0．01）及健康对照组CD34^＋CD59 ^-细胞（59±23，P〈0．05）；PNH患者CD34^＋CD59 ^-细胞P—STAT5的MFI与健康对照组CD34^＋CD59 ^-细胞比较差异无统计学意义（P〉0．05）。（2）EPO、TPO刺激后，PNH患者CD34^＋CD59 ^-细胞P．STAT5的MFI分别为49±24、51±41，明显低于CD34^＋CD59 ^-细胞（120±82、124±87，均P〈0．01）及健康对照组CD34^＋CD59 ^-细胞（79±47、98±53，均P〈0．05），PNH患者CD34^＋CD59 ^-细胞P—STAT5的MFI与健康对照组CD34^＋CD59 ^-细胞比较差异无统计学意义，经EPO、TPO刺激后PNH患者CD34^＋CD59 ^-细胞P-STAT5的增高值分别为49±11、54±43，明显高于CD34^＋CD59 ^-细胞（17±4、16±6，均P〈0．01）。结论体外予EPO、TPO刺激，PNH患者正常克隆造血干细胞（CD34^＋CD59 ^-）EPO、TPO受体后信号转导通路中STAT5磷酸化水平明显优于异常克隆造血干细胞（CD34^＋CD59 ^-）。

Objective To study the STAT5 phosphorylation levels of erythropoietin receptor （EPOR） and thrombopoietin receptor （TPOR） in CD34 ^＋ CD59^- and D34 ^＋ CD59^- bone marrow cells of the patients with paroxysmal nocturnal hemoglobinuria （PNH）. Methods The bone marrow mononuclear cells （BMMNC） were extracted from 23 PNH patients treated at our department from April 2010 to February 2011 and 11 normal controls. The mean fluorescence intensity （MFI） of phosphorylated STAT5 （P-STAT5） in CD34 ^＋ CD59^- cells and CD34 ^＋ CD59^ - cells with or without the stimulation of 10 U/ml EPO and 50 U/ml TPO were examined by flow cytometry. Results （ 1 ） Without stimulation, the P-STAT5 MFI in CD34 ^＋ CD59 ^- cells of PNH patients was significantly lower than that of CD34 ^＋ CD59^- cells （ 31 ± 15 vs 74± 47, P 〈 0. 01 ）. And it was 59 ± 23 in normal control CD34 ^＋ CD59^- cells （ P 〈 0.05 ）. No statistic difference existed between the CD34 ^＋ CD59^- cells of PNH patients and the normal control CD34 ^＋ CD59^- cells. （ 2 ） Under the stimulations of EPO and TPO, the P-STAT5 MFI was significantly lower in CD34 ^＋ CD59 ^- cells of PNH patients than that of CD34 ^＋ CD59^- cells （49 ＋ 24 and 51 ＋ 41 vs 120 ± 82 and 124± 87, both P 〈 0. 01 ）. For the normal control CD34 ^＋ CD59^- cells, they were 79 ± 47 and 98± 53 respectively （P 〈 0.05）. No statistic difference existed between the CD34 ^＋ CD59^- cells of PNH patients and the normal control CD34 ^＋ CD59^- cells. P-STAT5 MFI was elevated after the stimulations of EPO and TPO. The increments of CD34 ^＋ CD59^- cells in PNH patients were significantly higher than those of CD34 ^＋ CD59 - cells （49 ± 11 and 54 ±43 vs 17 ± 4 and 16 ± 6, both P 〈 0. 01 ）. Conclusion Under the in vitro stimulations of EPO and TPO, the STAT5 phosphorylation levels of EPO and TPO receptors in normally cloned hematopoietic stem cells in PNH patients are obviously superior to those in abnormally cloned counterparts.