免疫相关性全血细胞减少症患者外周血淋巴细胞端粒长度研究  

Telomere length of peripheral lymphocytes in patients with immuno-related pancytopenia

作　　者：张江勃 付蓉[1] 王一浩[1] 李丽娟[1] 刘惠[1] 丁凯[1] 刘春燕[1] 张田[1] 丁少雪[1] 阮二宝[1] 瞿文[1] 王化泉[1] 王晓明[1] 王国锦[1] 吴玉红[1] 宋嘉[1] 刘鸿[1] 邢莉民[1] 关晶[1] 邵宗鸿[1] 

机构地区：[1]天津医科大学总医院血液内科,300052

出　　处：《中华血液学杂志》2014年第7期605-608,共4页Chinese Journal of Hematology

基　　金：国家自然科学基金（30971285、81370607、81170472）;天津市抗癌重大专项攻关计划（12ZCDZSY17900、12ZCDZSY18000）;天津市自然科学基金（12JCZDJC21500、14JCYBJC25400）;天津医科大学基金（2011ky07、2010ky20）;天津市卫生局科技基金（2011KZ115、2010KZ105）;天津市卫生行业重点攻关项目（11KG135）

摘　　要：目的 检测免疫相关性全血细胞减少症（IRP）患者外周血CD3＋、CD3＋CD4＋、CD3＋CD8＋、CD19＋淋巴细胞及骨髓CD34＋细胞端粒长度变化并分析其与病情严重程度的关系.方法 以40例初治IRP患者为研究对象,应用免疫磁珠方法分选外周血CD3＋、CD3＋CD4＋、CD3＋CD8＋T淋巴细胞,CD19＋B淋巴细胞及骨髓CD34＋细胞,以流式细胞术-荧光原位杂交技术检测端粒相对长度,并分析端粒长度与IRP患者病情严重程度的相关性.结果 初治IRP患者外周血CD3＋、CD3＋CD4＋、CD3＋CD8＋T淋巴细胞端粒相对长度分别为（27.754±16.323）％、（7.526±3.745）％、（25.854±14.789）％,与健康志愿者的（54.555± 19.782）％、（12.096±2.805）％、（38.367±4.626）％比较明显缩短（P＜0.05）;IRP患者外周血CD19＋B淋巴细胞端粒相对长度为（22.136±16.142）％,与健康志愿者的（42.846±16.353）％比较亦明显缩短（P＜0.01）;IRP患者骨髓CD34＋细胞端粒相对长度为（22.528±21.601）％,与健康志愿者的（23.936±19.822）％比较差异无统计学意义（P＞0.05）.B淋巴细胞端粒相对长度与外周血白细胞计数呈正相关（r=0.706,P=0.015）,而与临床表现积分呈负相关（r=-0.613,P=0.045）,与治疗效果呈正相关（r=0.775,P=0.005）.结论 初治IRP患者存在CD3＋、CD3＋CD4＋、CD3＋CD8＋T淋巴细胞及CD19＋B淋巴细胞端粒长度的缩短,且与IRP病情严重程度相关;骨髓CD34＋细胞端粒长度无明显异常.该结果提示IRP为一种后天获得性自身免疫性疾病.Objective To investigate the changes of relative telomere length （RTL） of peripheral blood （PB） CD3＋,CD3＋CD4＋,CD3＋CD8＋T lymphocytes,CD19＋B lymphocytes and bone marrow （BM） CD34 ＋ cells and its association with disease severity in untreated patients with immuno-related pancytopenia （IRP）.Methods The PB CD3 ＋,CD3 ＋ CD4＋,CD3 ＋ CD8 ＋T lymphocytes,CD19 ＋B lymphocytes,and BM CD34＋ cells were purified by magnetic activated cell sorting （MACS）,and RTL were measured with flow-fluorescence in situ hybridization （FLOW-FISH）.Results The RTL of CD3＋,CD3＋CD4＋,and CD3＋CD8＋T lymphocytes in untreated IRP patients were （27.754± 16.323）％,（7.526± 3.745）％ and （25.854± 14.789）％,respectivly,which were significantly shorter than those in healthy controls （54.555± 19.782）％,（12.096±2.805）％,and （38.367±4.626）％ （P＜0.05）.The RTL of CD19＋ lymphocytes in untreated IRP patients was （22.136± 16.142）％,which was significantly shorter than that in healthy controls （42.846± 16.353）％ （P＜0.01）.There was no significant difference of BM CD34＋ cells RTL between the untreated IRP patients （22.528±21.601）％ and the healthy controls （23.936± 19.822）％（P＞0.05）.There were significantly positive correlations between the RTL of B lymphocytes and the count of white blood cell （r=0.706,P=0.015）.There were negative correlations between RTL of B lymphocytes and the clinical symptoms （r=0.613,P=0.045） and positive correlations with therapeutic effect （r=0.775,P=0.005）.Conclusions The shorter RTL of CD3 ＋,CD3 ＋CD4＋,CD3 ＋CD8＋,CD19＋ lymphocytes,and the normal RTL of BM CD34＋ cells in untreated IRP patients were identified,which might imply that IRP is a type of acquired autoimmune diseases.

关 键 词：全血细胞减少 自身免疫疾病 淋巴细胞亚群 端粒 

分 类 号：R55[医药卫生—血液循环系统疾病]