大量输血患者血小板自噬相关因子的差异表达  

Differential expression of platelet autophagy related factors in patients with massive blood Transfusion

作　　者：汪辉[1] 杨志平[1] 闫冬梅[1] 陈曦[2] 苗美娟[1] 贾瑞春[1] 赵弘[1] 刘菲[1] WANG Hui;YANG Zhiping;YAN Dongmei;CHEN Xi;MIAO Meijuan;JIA Ruichun;ZHAO Hong;LIU Fei(Department of Blood, Transfusion, the Second Affiliated Hospital, Harbin Medical University Harbin 150086, China;Department of Hematology,the Second Affiliated Hospital, Harbin Medical University)

机构地区：[1]哈尔滨医科大学附属第二医院输血科,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属第二医院血液科,黑龙江哈尔滨150086

出　　处：《中国输血杂志》2019年第6期557-560,共4页Chinese Journal of Blood Transfusion

基　　金：哈医大创新科学基金青年专项基金(2016LCZX16);黑龙江省卫生计生委科研课题(2017-059)

摘　　要：目的了解大量输血(MT)患者在输血前后血小板自噬相关因子的表达改变。方法采用备有EDTA-K2抗凝真空采血管采集患者大量输血前后静脉血,利用qRT-PCR检测血小板自噬相关基因Atg5和Atg7的表达,同时利用Western Blot检测血小板自噬相关蛋白Atg5、Atg7、LC3以及Akt/mTOR通路蛋白的表达。结果血常规检测输血后,患者Hct和Hb水平升高但Plt降低(P<0.05)。qRT-PCR检测输血后,患者血小板血浆Atg5(1.091±0.097 vs 4.929±0.402)和Atg7 (1.086±0.119 vs 3.771±2.113)的mRNA相对表达量均显著升高(P<0.01)。Western Blot检测输血后,患者血小板血浆Atg5(1.007±0.103 vs 3.435±1.842)、Atg7 (1.045±0.119 vs 2.682±1.570)和LC3Ⅱ/Ⅰ(1.022±0.104 vs 3.101±1.905)的蛋白表达量均显著升高(P<0.01)。大量输后患者血小板血浆及Rap处理后,LC3Ⅱ/Ⅰ表达量升高而p-Akt蛋白表达量降低(P<0.01);大量输血后血小板血浆及Tricirbine处理后,LC3Ⅱ/Ⅰ表达量升高而p-mTOR蛋白表达量降低(P<0.05)。结论大量输血能活化血小板自噬反应,这可能与抑制Akt/mTOR通路激活相关。Objective To investigate the changes of platelet autophagy related factors in patients with massive blood transfusion(MT) before and after blood transfusion.Methods Venous blood samples were collected from patients before and after MT with EDTA-K2 anticoagulant vacuum, and the expressions of platelet autophagy related genes(Atg5 and Atg7) were detected using qRT-PCR. At the same time, the expression of platelet autophagy associated proteins(Atg5, Atg7, LC3 and Akt/mTOR pathway) were detected using Western Blot.Results After massive transfusion, Hct and Hb levels in patients increased but Plt decreased(P<0.05);the relative expression of mRNA Atg5(1.091±0.097 vs. 4.929±0.402) and Atg7(1.086±0.119 vs. 3.771±2.113) increased significantly in patients with platelet plasma(P<0.01). After massive transfusion, the protein expression levels Atg5(1.007±0.103 vs. 3.435±1.842), Atg7(1.045±0.119 vs. 2.682±1.570) and LC3 Ⅱ/Ⅰ(1.022±0.104 vs. 3.101±1.905) were significantly increased(P<0.01). After massive transfusion in patients with treatment of Rap, the expression of LC3 Ⅱ/Ⅰ increased and the expression of p-Akt protein decreased(P<0.01). After massive transfusion in patients with treatment of Tricirbine, the expression of LC3 Ⅱ/Ⅰ increased and the expression of p-mTOR protein decreased(P<0.05).Conclusion Massive transfusion could activate platelet autophagy, which may be associated with the inhibition of Akt/mTOR pathway activation.

关 键 词：大量输血 血小板自噬 自噬因子 Akt/mTOR通路 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]