再生障碍性贫血外周血和骨髓免疫活性分子变化及临床意义

目的:研究免疫活性分子异常在再生障碍性贫血（AA）发病中的作用及临床意义。方法:应用ELISA测定AA患者骨髓（BM）及外周血（PB）白介素-2（IL-2）、Flt3配体（FL）、可溶性Fas配体（sFasL）的含量变化。结果:AA患者BM及PB中IL-2含量均显著升高;与正常对照相比,该种变化在急性AA尤为明显（P<0.01）,绝大部分患者sFas-L含量增加;FL水平升高尤为显著,达正常水平的25倍以上,且PB与BM的浓度无区别,经治疗有效者IL-2、sFasL和FL明显下降,但sFasL和FL水平不能恢复正常,动态测定表明IL-2、sFas-L和FL的含量与临床疗效密切相关。结论:AA患者PB和BM中免疫活性分子增多是其自身反应性T细胞的异常活化原因之一,定期测定IL-2、sFasL和FL有助于预后判断。

The changes of immunologic molecules in bone marrow and peripheral blood of aplastic anemia patients and its implication on clinical outcome

Objective:To investigate the effect of immunologic molecules in development of aplastic anemia(AA) and its clinical significance. Methods: Enzyme-linked immunoadsorbent assay(ELISA) were employed to determine the levels of interleukin-2(IL-2),flt3 ligand (FL) ,and soluble Fas ligand(sFasL) peripheral blood(PB) and bone manow(BM) of AA patients. Results:The levels of IL-2 in PB and BM of AA patients increased significantly in comparison with controls, especially in those with serious AA( P < 0.05). The levels of soluble Fas li-gand(sFasL) increased in most of patients.The levels of FL was 25 times as high as those in controls and the levels in PB or BM were no statistical difference.The levels of those immunologic molecules would decrease after effective treatment, but the levels of sFasL and FL didn' t return to normal. Dynamic monitoring showed that the levels of IL-2,sFasL and F1 were paralled to clinical outcome.Conclusion: Highly elevated IL-2,FL and sFasL in PB and BM of AA patients were characteristic changes during the process of the disease and contributed to its disturbance of immunologic system. Dynamic monitoring the levels of these molecules may represent an important prognostic factor of the likely outcome in AA patients.