再生障碍性贫血造血细胞Fas抗原表达与T淋巴细胞功能的研究

目的 研究造血细胞凋亡与T淋巴细胞免疫在再生障碍性贫血(再障，Aplastic anemia，AA)发病机制中的作用及两者相关性。方法 采用流式细胞仪测定40例AA患者和15例非血液、免疫系统疾病对照者骨髓单个核细胞(BMMNC)的总CD34^ 、CD34^ Fas^ 、CD34^ Fas^-、CD3^ 、CD8^ 、CD3^ 、CD3^ CD25^ 标记值。结果 (1)与对照组比较，AA组总CD34^ 细胞％明显减少而其Fas表达率(以占总CD34^ 细胞％为计)明显增高。(2)AA组CD34^ 细胞％数与其Fas抗原表达率无明显负相关。(3)AA组T细胞％明显增多，且以CD8^ 细胞和CD3^ CD25^ 细胞增多为主。(4)AA组CD34^ 细胞％数与其T细胞活化状态无显著负相关。(5)AA组CD34^ 细胞Fas表达率与其T细胞活化状态无显著正相关。结论 AA骨髓存在着造血细胞数量减少和T淋巴细胞亚群数量、功能的异常，造血细胞数量减少还可能与Fas以外途径诱导的凋亡过度有关。骨髓造血细胞凋亡过度可能有活化T淋巴细胞免疫以外的途径诱导Fas途径或活化T淋巴细胞可以通过Fas之外的途径诱导造血细胞凋亡。

Studies of Expression of Fas Antigen on Hematopoietic Cells and T Lymphocytic Function in Patients with Aplastic Anemia

Objective To evaluate the effects of hematopoietic cells apoptosis and T lymphatic cellular immune function on the pathogenesis of aplastic anemia(AA)and their correlations.Methods Expression of Fas antigen on CD 34 + cells and T lymphocyte subsets,CD 25 + antigen on CD 3 + cells in the bone marrow mononuclear cells in 40 AA patients(CAA 24,AAA 16)and 15 normal controls were assayed by using flow cytometry.Results:CD 34 + cells and CD 4 +/CD 8 + ratio were lower,and CD 34 + Fas + cells,CD 8 + cells,CD 33 + cells,CD 3 +CD 25 +cells were higher in AA patients than that in normal controls.Every index value of them in AA patients,except CD 3 +cells and CD 4 +cells only in CAA patients,showed significant difference in comparison to normal control.Respectively,CD 34 +cells level. CD 34 + Fas + cells level was no markedly lineally positive or negative correlated with CD 3 + and CD 25 + cells value.CD 34 + cells and CD 8 + cells were higher,and CD 34 +Fas +cells,CD 3 +cells,CD 3 +CD 25 +cells were lower in CAA patients than in AAA ones,however,there was no significant difference between two groups.Conclusion The decreased numbers of CD 34 +cells in the bone marrow related to Fas-mediated overapoptosis of themselves may have been implicated in pathogenesis of AA.There may be other pathways by which to cause the deficiency of CD 34 +cells, besides Fas-mediated apoptosis pathway.The abnormity in T lymphocyte subsets and their function may have played an important role in the pathophysiology of immune-mediated AA.Overapoptosis of progenitors and stem cells were induced by more than activated T lymphocyte-mediated pathway. In addition to Fas-triggered apoptosis,other pathways may have been suggested as an effector mechanism by which T lymphocyte eliminate their targets.