PNH患者淋巴细胞CD_(59)和CD_(45)的表达  

Expression of CD_(59) and CD_(45) on lymphocytes in paroxysmal nocturnal hemoglobinuria patients

作　　者：崔巍[1] 张之南[1] 

机构地区：[1]中国医学科学院,中国协和医科大学北京协和医院,100730

出　　处：《中华血液学杂志》2002年第2期77-79,共3页Chinese Journal of Hematology

摘　　要：目的　分析阵发性睡眠性血红蛋白尿症 (PNH)患者淋巴细胞及其亚群上糖化肌醇磷脂结合蛋白 (CD59)的表达和功能转化。方法　采用流式细胞术多色分析法 ,配合多种细胞特异性抗体 ,对PNH患者不同类型的淋巴细胞及其亚群上CD59的表达进行分析 ,并通过细胞刺激实验对CD59表达阴性和部分阳性的异常淋巴细胞 (即病态细胞 )表面分化抗原CD45异构表型的功能转化进行研究。结果　 14例PNH患者病态淋巴细胞的百分率较病态的中性粒细胞和红细胞低 ;所有PNH患者均可检测到病态B淋巴细胞的存在 ,B淋巴细胞病态比例高于NK细胞和T细胞 ;在T细胞亚群中 ,抑制性T细胞病态比例高于辅助性T细胞 (P <0 .0 0 1) ;病态T细胞上HLA DR和CD45RO 的表达率明显低于正常T细胞 (CD59表达完全阳性的细胞 ) (P <0 .0 1) ,而其CD45RA 的表达率明显高于正常T细胞 (P <0 .0 1) ;病态T细胞经植物血凝素刺激后培养 7d ,其CD45RA的表达率明显下降 (中位数从 82 .7%降至 2 6 .6 % ) ,而CD45RO 表达率明显升高 (中位数由 19.6 %升至 6 4.3% )。结论　PNH患者各种淋巴细胞及其亚群均存在病态细胞 ,B淋巴细胞上CD59的表达情况可作为诊断PNH的指标 ,病态的T淋巴细胞以无活性的初始细胞 (CD45RA+HLA DR- )为主 ,受到抗原刺激后 。Objective To analyse the expression of glycosylphosphatidylinositol (GPI)-anchored protein and functional transition of lymphocyte subsets in paroxysmal nocturnal hemoglobinuria (PNH) patients. Methods Flow cytometer and multi-color McAbs were used to detect CD 59 expression on lymphocytes and their subsets. Stimulation test was used to examine the ability of affected T cells in converting from CD 45RA phenotype to CD 45RO phenotype. Results In 14 PNH samples, CD 59 expression on affected lymphocytes was at a lower percentage than that on granulocytes and erythrocytes. B lymphocytes were widely affected than NK or T cells. CD 59 -deficient B lymphocytes existed in all PNH patients. More CD 8 + T cells were affected than CD 4 + T cells. Expression of HLA-DR and CD 45RO on affected T cells were significantly lower than that on normal T cells (P<0.01), whereas the expression of CD 45RA was much higher on the former (P<0.01). After stimulation with phytohemagglutinin (PHA), the expression of CD 45RA + on affected T cells decreased sharply (the median value was from 82.7% to 26.6%),while the expression of CD 45RO + increased significantly (the median value was from 19.6% to 64.3% ). Conclusions The deficient CD 59 phenotype does involve in the different types of lymphocytes in PNH patients. Therefore affected B cells could be a good marker for diagnosis of PNH. The affected T cells were mainly comprised naive cells (CD 45RA +HLA-DR -), which could acquire the memory phenotype (CD 45RO +HLA-DR +) after stimulated by antigen.

关 键 词：阵发性血红蛋白尿 淋巴细胞亚群 抗原 CD59 CD45 诊断 

分 类 号：R556.62[医药卫生—血液循环系统疾病]