铁代谢红系调节因子在不同类型红系造血异常疾病中的表达

Expression of iron-regulating erythroid factors in different types of erythropoiesis disorders

目的研究Erythroferrone(ERFE)等铁代谢红系调节因子(iron-regulatory erythroid factor)在不同类型红系造血异常疾病中的表达情况。方法采用ELISA方法检测2016年1月至2019年11月共47例真性红细胞增多症(PV)、纯红细胞再生障碍(PRCA)、自身免疫性溶血性贫血(AIHA)和骨髓增生异常综合征(MDS)患者血浆ERFE、生长分化因子15(GDF15)、生长分化因子11(GDF11)和扭转原肠胚形成同系物(TWSG1)的表达,分析铁代谢调节因子与红系造血异常类型及旺盛程度(以骨髓有核红细胞比例反映)的适配性。结果血浆GDF15表达水平在PV、PRCA、AIHA、MDS各组依次为266.01(112.40,452.37)、110.63(81.41,220.42)、52.11(32.61,171.66)、276.53(132.16,525.70)ng/L,均显著高于正常对照组的37.45(19.65,57.72)ng/L(P值均<0.01)。不同类型红系造血异常患者血浆TWSG1表达水平与正常对照组比较差异均无统计学意义(P值均>0.05)。血浆GDF11表达水平仅在PV组患者中明显高于正常对照组[74.75(10.95,121.32)ng/L对36.90(3.38,98.34)ng/L,P<0.01],而PRCA、AIHA、MDS 3组患者与正常对照组比较差异无统计学意义(P>0.05)。PV组血浆ERFE水平为129.63(47.02, 170.03)ng/L,AIHA组血浆ERFE水平最高为121.76(68.12,343.11)ng/L,二者均明显高于正常对照组的43.23(35.18,65.41)ng/L(P值均<0.01);PRCA组、MDS组血浆ERFE水平分别为48.92(44.59,84.83)、40.47(26.97,72.87)ng/L,与正常对照组比较差异无统计学意义(P值均>0.05)。骨髓有核红细胞比例与ERFE(r=0.458,P=0.001)呈正相关,而与GDF15(r=-0.163,P=0.274)、GDF11(r=0.120,P=0.421)、TWSG1(r=-0.166,P=0.269)无明显相关性。结论铁代谢红系调节因子在不同红系造血异常疾病的表达谱不尽一致,ERFE与红系造血旺盛程度相关度最高。

Objective To investigate the expression of iron-regulating erythroid factors in different types of erythropoiesis disorders.Methods From January 2016 to November 2019,the plasma concentrations of iron-regulating erythroid factors were measured by ELISA methods in 47 patients with different types of erythropoiesis disorders.The adaptation orientation of iron-regulating erythroid factor expression with bone marrow erythropoiesis activities(represented by bone marrow-nucleated erythrocytes ratio)was analyzed.Results The median plasma growth differentiation factor(GDF)15 levels in patients with polycythemia vera(PV),pure red cell aplasia(PRCA),autoimmune hemolytic anemia(AIHA),and myelodysplastic syndrome(MDS)were 266.01 ng/L(112.40,452.37),110.63 ng/L(81.41,220.42),52.11 ng/L(32.61,171.66),and 276.53(132.16,525.70)ng/L,respectively,which were significantly higher than those in normal patients with 37.45(19.65,57.72)ng/L(all P<0.01).The plasma TWSG1 expression levels were not significantly different in patients with PV,PRCA,AIHA,and MDS from those of normal patients(P>0.05).The median plasma GDF11 level in PV was 74.75(10.95,121.32)ng/L,which was significantly higher than 36.90(3.38,98.34)ng/L in normal control subjects(P<0.01).However,no statistical differences were observed in the other three subjects(P>0.05).The median plasma erythroferrone(ERFE)levels in AIHA and PV were 121.76 ng/L(68.12,343.11)and 129.63(47.02,170.03)ng/L,respectively,with the highest level in AIHA in all the studied types of erythropoiesis disorders.The bone marrow-nucleated erythrocytes ratio was significantly and positively correlated with ERFE(r=0.458,P=0.001)but not with GDF15(r=-0.163,P=0.274),GDF11(r=0.120,P=0.421),and TWSG1(r=-0.166,P=0.269).Conclusion The expression profile of iron-regulating erythroid factors is not exactly the same in different types of erythropoiesis disorders.ERFE demonstrated the highest correlation with erythropoiesis activities.