免疫性血小板减少症患者来源的骨髓间充质细胞对巨核细胞生物学行为的影响  

Effects of bone marrow mesenchymal cells from immune thrombocytopenia patients on the biological behaviors of megakaryocytes

作　　者：王君颖 李昕[1] 殷婷玉[2] 刘佳[2] 王晓栋[3] 钟华[1] WANG Jun-ying;LI Xin;YIN Ting-yu;LIU Jia;WANG Xiao-dong;ZHONG Hua(Department of Hematology,South Campus,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201112,China;Department of Hematology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Rheumatology,South Campus,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201112,China)

机构地区：[1]上海交通大学医学院附属仁济医院南院血液科,上海201112 [2]上海交通大学医学院附属仁济医院血液科,上海200127 [3]上海交通大学医学院附属仁济医院南院风湿科,上海201112

出　　处：《上海交通大学学报（医学版）》2018年第6期616-623,共8页Journal of Shanghai Jiao tong University:Medical Science

基　　金：仁济南院临床多学科合作共建项目(2014MDT01-07)~~

摘　　要：目的·研究免疫性血小板减少症(immune thrombocytopenia,ITP)患者来源的骨髓间充质细胞(bone marrow mesenchymal cells,BMCs)体外生存能力、细胞因子表达的变化以及对巨核细胞生物学行为的影响。方法·全骨髓贴壁培养法培养7名ITP患者及5名正常对照者(normal controls,NC)来源的BMCs,流式细胞术检测BMCs基础凋亡率并进行表型鉴定,CCK-8法检测细胞增殖能力。佛波酯诱导HEL细胞分化并将诱导后的HEL(induced HEL,in HEL)分为3组:in HEL单独培养组(a组)、in HEL与ITP患者来源的BMCs共培养组(b组)、in HEL与NC来源的BMCs共培养组(c组),72 h后检测3组in HEL的凋亡率及CD41a、CD42b的表达状况。实时荧光定量PCR及酶联免疫吸附试验检测BMCs中细胞因子IL6、IL11、TPO、SCF的基因及蛋白表达水平。结果·与NC相比,ITP患者来源的BMCs体外增殖减弱(第4日,P=0.039;第6、10日,P=0.009;第8日,P=0.007),基础凋亡率增加[早期凋亡率(AV+PI-),P=0.036;晚期凋亡率(AV+PI+),P=0.003;总凋亡率(AV+PI-/+),P=0.004];IL6基因及蛋白表达减少、SCF基因表达减少(均P=0.000),而TPO及IL11表达量无明显差别。c组细胞CD41a表达量与a组相比显著增加(P=0.000);b组细胞CD41a表达量与a组相比有所增加(P=0.015),但仍显著少于c组(P=0.000)。与a组相比,b组、c组细胞的早期及总凋亡率以及c组细胞的晚期凋亡率均明显降低(均P=0.000),而b组细胞晚期凋亡率无明显变化;与c组相比,b组细胞的晚期及总凋亡率均明显升高(均P=0.000)。结论·ITP患者来源的BMCs在体外共培养条件下对巨核细胞分化及生存的支持能力减弱,其机制与ITP来源的BMCs细胞因子IL6、SCF的表达量减少相关。Objective·To investigate changes of immune thrombocytopenia(ITP)patients-derived bone marrow mesenchymal cells(BMCs)in cells survival,cytokines expression as well as the effects of BMCs on the biological behaviors of megakaryocytes.Methods·BMCs were collected from 7 ITP patients and 5 normal controls(NC),and cultivated by the whole marrow adherent method.Surface markers and basal apoptosis rate of BMCs were analyzed by flow cytometry(FCM).Proliferation of BMCs was assessed by CCK-8 method.Phorbol 12-myristate 13-acetate(PMA)was used to stimulate differentiation of HEL cells.The induced HEL cells(inHEL)were divided into 3 groups:inHEL cultured alone(group a),inHEL co-cultured with BMCs derived from ITP patients(group b),inHEL co-cultured with BMCs derived from NC(group c).After 72 h incubation,the expression of cell surface proteins(CD41a,CD42b)and cell apoptosis rate were analyzed by FCM.The mRNA and proteins expression levels of cytokines IL6,IL11,TPO,SCF were detected by real-time fluorescent quantitative PCR(RT-qPCR)and enzyme linked immunosorbent assay(ELISA),respectively.Results·Compared with NC,BMCs from ITP patients grew progressively slowly(Day 4,P=0.039;Day 6,10,P=0.009;Day 8,P=0.007),cell basal apoptosis rates were increased[AV+PI-(early apoptosis rate),P=0.036;AV+PI+(late apoptosis rate),P=0.003;AV+PI-/+(total apoptosis rate),P=0.004].Compared with group a,the expression of CD41a in group c was much higher(P=0.000).The expression of CD41a in group b was higher than that in group a(P=0.015),but still much less than that in group c(P=0.000).Compared with group a,the early and total apoptosis rate in group b,c and the late apoptosis rate in group c were decreased obviously(all P=0.000),whereas there was no obvious change of the late apoptosis rate in group b.However,compared with group c,the late and total apoptosis rate in group b were significantly increased(both P=0.000).The expression levels of IL6,SCF mRNA and IL6 protein were significantly decreased in ITP BMCs(all P=0.000),but there was no obvio

关 键 词：免疫性血小板减少症 骨髓间充质细胞 巨核分化及血小板生成 发病机制 治疗靶标 

分 类 号：R558.2[医药卫生—血液循环系统疾病]