免疫相关性全血细胞减少症患者骨髓B淋巴细胞数量、功能及凋亡

The quantity, function and apoptosis of B lymphocyte in patients with immunorelated pancytopenia

目的检测免疫相关性全血细胞减少症(IRP)患者骨髓B淋巴细胞的数量、功能及凋亡相关蛋白水平,以探讨B淋巴细胞在IRP发病中的作用。方法采用流式细胞术测定25例初诊患者,15例治疗后血象恢复正常的患者和10例正常人骨髓总B淋巴细胞、CD5^+B淋巴细胞细胞的数量,B淋巴细胞胞浆内免疫球蛋白IgM的表达以及B淋巴细胞膜表面凋亡相关蛋白Fas抗原(CD95)、胞浆内抗凋亡蛋白bcl—2的表达。结果 IRP初诊患者总B淋巴细胞、CD5^+B淋巴细胞比例显著高于治疗后血象恢复组和正常人(P均<0.05),后两组相比无显著性差异(P>0.05);初诊患者骨髓B淋巴细胞免疫球蛋白IgM的表达也明显高于其他两组。三组患者B淋巴细胞Fas抗原的表达率无明显区别(P均>0.05);初诊患者B淋巴细胞胞浆内bcl—2的表达率显著高于其它两组(P均<0.05),治疗后血象恢复组也显著高于正常对照组(P<0.01);各组间B淋巴细胞凋亡相关指数(CD19^+CD95^+/CD19^+Bcl-2^+)比较,初诊组显著低于治疗后血象恢复组和对照组(P均<0.01),治疗后血象恢复组也显著低于对照组(P<0.05);B淋巴细胞的比例与治疗起效时间呈正相关(r=0.69,P<0.01)。结论 IRP患者自身抗体的产生可能与B淋巴细胞及其亚群数量异常、功能亢进及凋亡受抑有关。

Objective To measure the quantities, function and apoptosis-related protein levels of B lymphocyte in the patients with Imunorelated pancytopenia (IRP) and explore the action of B lymphocyte in the pathogenic mechanism of IRP. Methods Quantities of whole B lymphocytes and CD5 + B lymphocytes and the expressions of IgM, Fas and Bcl-2 of B lymphocytes in 25 patients with un-treated IRP, 15 IRP patients in complete remission (CR) and 10 normal controls were assayed by FACS. Results The percentages of B lymphocyte and CD5+ B lymphocytes of untreated IRP patients were significantly higher than those of CR IRP patients and normal controls (P < 0.05) , there was no significant difference between the latter two groups (P> 0.05) .The expression of IgM was significantly higher in intreated IRP patients than those in CR patients and normal controls (P<0.05), there was no significant difference between the latter two groups (P<0.05) .There was no significant difference of Fas expressions in B lymphocytes among three groups (P> 0.05); The expression of Bcl-2 in B lymphocytes in untreated patients was significantly higher than that in CR patients or normal controls (P < 0.05), and significantly higher in CR patients than that in normal controls (P< 0.01); The apoptosis-related index in untreated patients was significantly lower than that in CR patients or normal controls (P<0.01), was significantly lower in CR patients than that in normal controls (P<0.05); The percentage of B lymphocyte was positively correlated with post-treated response time. Conclusions The production of auto-antibodies in IRP patients probably has some relationships with the abnormal quantites, function of B lymphocyte and its subgroups, and inhibition of B lymphocyte apoptosis.