Tim3在再生障碍性贫血和骨髓增生异常综合征鉴别诊断中的意义

The clinical significance of Tim3 in differential diagnosis of aplastic anemia and myelodysplastic syndrome

目的:探究T细胞免疫球蛋白黏液素(T cell immunoglobulin and mucin,Tim)3在再生障碍性贫血(aplastic anemia,AA)和骨髓增生异常综合征(myelodysplastic syndrome,MDS)鉴别诊断中的意义。方法:流式细胞术检测24例AA患者、20例MDS患者和17例健康对照者外周血单个核细胞(peripheral blood mononuclear cells,PBMC)中CD4^+Tim1^+和CD4^+Tim3^+细胞比例。实时荧光定量PCR检测AA、MDS患者和健康对照者PBMC中Tim3 m RNA和S型凝集素半乳糖凝集素9(galectin-9,Gal-9)mRNA表达水平。结果:健康对照者、AA和MDS患者PBMC中CD4^+Tim1^+细胞比例差异无统计学意义;MDS患者的CD4^+Tim3^+细胞比例明显高于AA患者和健康对照者(P<0.05);高危组MDS患者CD4^+Tim3^+细胞比例明显高于低中危组MDS患者(P<0.01)和健康对照者(P<0.05);健康对照者、AA和MDS患者的Tim3 m RNA和Gal-9 mRNA水平差异无统计学意义。结论:MDS患者Tim3表达水平明显高于AA患者,并与疾病危险度有关,提示Tim3可能参与MDS的发病,并可能成为临床鉴别AA与MDS的标志物。

Objective:This study aims to investigate the clinical significance of Tim3 in differential diagnosis of aplastic anemia(AA)and myelodysplastic syndrome(MDS).Methods:The proportion of CD4^+Tim1^+and CD4^+Tim3^+cells in peripheral blood mononuclear cells(PBMC)from 24 AA patients,20 MDS patients,and 17 normal controls were detected by flow cytometry.Real time qPCR was performed to examine Tim3 mRNA and Gal-9 mRNA levels in PBMC.Results:There was no difference of the proportion of CD4^+Tim1^+cells in PBSC among normal control,AA,and MDS groups;The proportion of CD4^+Tim3^+cells in MDS patients was significantly higher than that in patients from AA and control groups(P<0.05);The percentage of CD4^+Tim3^+cells was significantly increased in high-risk MDS patients compared with that in low-or medium-risk MDS patients(P<0.01)and healthy controls(P<0.05).There was no difference of Tim3 mRNA and Gal-9 m RNA levels in PBSC among normal control group,AA group,and MDS group.Conclusion:Tim3 in MDS patients is significantly higher than that in AA patients and is related to the risk of disease.These findings suggest that Tim3 might be involved in the pathogenesis of MDS and might be utilized as a marker to distinguish AA and MDS.