免疫相关性全血细胞减少症患者树突状细胞数量及功能的研究

发布时间：2018-04-16 13:31

本文选题：全血细胞减少 + 免疫相关　；参考：《天津医科大学》2012年硕士论文

【摘要】：目的：研究免疫相关性全血细胞减少症(immuno-related pancytopenia, IRP)患者外周血树突状细胞(dendritic cell, DC)数量和功能,探讨DC在IRP发病中的作用。方法：研究对象为65例IRP患者,其中初治患者(初治组)37例、经免疫抑制及促造血治疗后血象恢复正常患者(恢复组)28例、正常对照17名。采用流式细胞术(FCM)检测IRP患者外周血mDC (myeloid dendritic cell) (Lin-HLA-DR+CD11c+细胞)、pDC (plasmacytoid dendritic cell)(Lin-HLA-DR+CD123+细胞)数量及其表面共刺激分子CD80、CD86的表达水平。分析mDC、pDC、pDC/mDC及mDC、pDC表面共刺激分子CD80、CD86的表达水平与Th1/Th2比例、CD19+/骨髓单个核细胞(BMMNC)比例、BMMNC抗体(IgG)数量及血象的相关性。结果： 1、IRP初治组pDC占外周血单个核细胞(PBMNC)的比例为(0.91±0.64)%,明显高于恢复组(0.39±0.11)%和正常对照组(0.29±0.13)%(p0.01,p0.01),恢复组明显高于正常对照组(p0.05)；IRP初治细、恢复组外周血mDC占PBMNC的比例分别为(0.21±0.20)%、(0.34±0.21)%,与正常对照组(0.29±0.09)%比较均无统计学意义；IRP初治组pDC/mDC比值为6.75±6.11,明显高于恢复组(1.55±0.93)和正常对照组(1.07±0.43)(p0.01,p0.01),恢复组与对照组比较没有明显差别(p0.05)。 2、IRP初治组外周血pDC表面CD80的表达水平为(6.31±4.49)%,明显高于恢复组(3.09±2.93)%和正常对照组(2.33±2.25)%(p0.05,p0.05),而恢复组外周血pDC表面CD80的表达水平与正常对照组比较差异无统计学意义(p0.05);IRP初治组、恢复组外周血pDC表面CD86表达水平分别(82.47±13.17)%、(60.08±14.29)%,均明显高于正常对照组(47.95±18.59)%(p0.05,p0.05),初治组外周血pDC表面CD86的表达水平明显高于恢复组(p0.05)；IRP初治组、恢复组外周血mDC表面CD80表达水平分别为(6.20±5.44)%、(3.97±3.24)%,均明显高于正常对照组(1.86±1.73)%(p0.05,p0.05),初治组与恢复组比较差异无统计学意义(p0.05)；IRP初治组外周血mDC表面CD86表达水平为(97.06±4.82)%、恢复组为(95.58±6.51)%、正常对照组为(91.35±12.2)%,初治组明显高于正常对照组(p0.05)。 3、IRP组外周血pDC占PBMNC的比例与Th1/Th2呈负相关(r=-0.347,p0.05),与BMMNC抗体(IgG)数量呈正相关(r=0.606,p0.05),与CD19+/BMMNC呈正相关(r=0.709,p0.05),与血红蛋白和血小板水平均呈负相关(r=-0.381,p0.01)(r=-0.343,p0.01)；mDC占PBMNC的比例与Th1/Th2呈正相关(r=0.595,p0.05),与血红蛋白水平呈正相关(r=0.292,p0.05)；pDC/mDC与Th1/Th2水平呈负相关(r=-0.395,p0.05)与BMMNC抗体(IgG)数量呈正相关(r=0.421,p0.05),与CD19+/BMMNC呈正相关(r=0.423,p0.05),与血红蛋白和血小板水平均呈负相关(r=-0.304,p0.05)(r=-0.287,p0.05)；IRP组外周血pDC表面共刺激分子CD80表达水平与血红蛋白、血小板呈负相关(r=-0.431,p0.05)(r=-0.464,p0.05)；CD86表达水平与Th1/Th2呈负相关(r=-0.733,p0.05),与BMMNC抗体(IgG)数量呈正相关(r=0.283,p0.05),与CD19+/BMMNC呈正相关(r=0.,436,p0.05),与血红蛋白、血小板、白细胞水平均呈负相关(r=-0.539：p0.05)(r=-0.519,p0.05)(r=-0.567,p0.05)；IRP组外周血mDC表面共刺激分子CD80表达水平与血红蛋白和白细胞水平呈负相关(r=-0.262,p0.05)(r=-0.31,p0.05);CD86表达水平与白细胞水平呈负相关(r=-0.245,p0.05)。结论：pDC在IRP患者中数量增加,功能亢进,且数量与功能状态的变化具有一致性,随着治疗有效,逐渐趋于正常。pDC在IRP免疫发病机制中可能发挥重要作用,有可能成为该疾病潜在的治疗靶点。
[Abstract]:Objective : To study the number and function of dendritic cell ( DC ) in peripheral blood mononuclear cells ( DCs ) in patients with immune - related panhematopenia ( IRPs ) , and to explore the role of DC in the pathogenesis of IRPs .

Methods : Sixty - five patients with IRPs were studied , including 37 patients with primary treatment ( initial treatment group ) , 28 patients with normal control group ( recovery group ) , 28 normal controls , and 17 normal controls after immunosuppressive therapy and hematopoietic treatment . The peripheral blood mDC ( DCs ) of patients with IRPs was detected by flow cytometry ( FCM ) .

The expression levels of CD80 and CD80 on the surface of mDC , pDC , pDC / mDC and mDC , pDC , pDC , pDC / mDC and mDC , pDC were analyzed . The expression levels of CD80 and CD80 on the surface of mDC , pDC , pDC / mDC and mDC , pDC were compared with those of the Th1 / Th2 ratio , the proportion of CD19 + / bone marrow mononuclear cells ( BMMNC ) , the number of BMMNC antibodies ( IgG ) and the blood image .

Results :

1 . The proportion of pDC in peripheral blood mononuclear cells ( PBMNC ) was ( 0.91 卤 0.64 ) % , significantly higher than that in the recovery group ( 0.39 卤 0.11 ) % and the normal control group ( 0.29 卤 0.13 ) % ( P 0.01 , p0.01 ) .
The proportion of mDC in peripheral blood of recovery group was ( 0.21 卤 0.20 ) % , ( 0.34 卤 0.21 ) % , compared with normal control group ( 0.29 卤 0.09 ) % , respectively .
The pDC / mDC ratio of the initial treatment group was 6.75 卤 6.11 , which was significantly higher than that in the recovery group ( 1.55 卤 0.93 ) and the normal control group ( 1.07 卤 0.43 ) ( p0.01 , p0.01 ) . There was no significant difference between the recovery group and the control group ( p < 0.05 ) .

2 . The expression level of CD80 on peripheral blood pDC was ( 6.31 卤 4.49 ) % , significantly higher than that in the normal control group ( 3.09 卤 2.93 ) % and the normal control group ( 2.33 卤 2.25 ) % ( P < 0.05 ) .
The level of CD80 expression in peripheral blood of recovery group was ( 6.20 卤 5.44 ) % , ( 3.97 卤 3.24 ) % , ( 3.97 卤 3.24 ) % and ( 3.97 卤 3.24 ) % , respectively .
The expression level of CDDCs in peripheral blood was ( 97.06 卤 4.82 ) % , ( 95.58 卤 6.51 ) % , ( 91.35 卤 12.2 ) % in the normal control group and ( 91.35 卤 12.2 ) % in the normal control group .

3 . The proportion of peripheral blood pDC to PBMNC was negatively correlated with Th1 / Th2 ( r = - 0.347 , p0.05 ) , positively correlated with the quantity of BMMNC antibody ( IgG ) ( r = 0.709 , p0.01 ) ( r = - 0.381 , p0.01 ) ( r = - 0.343 , p0.01 ) .
The ratio of mDC to PBMNC was positively correlated with Th1 / Th2 ( r = 0.595 , p0.05 ) and positively correlated with hemoglobin level ( r = 0.292 , p0.05 ) .
There was a negative correlation between the levels of pDC / mDC and Th1 / Th2 ( r = - 0.395 , p0.05 ) and the number of BMMNC antibodies ( IgG ) ( r = 0.421 , p0.05 ) , which was positively correlated with the levels of CD 19 + / BMMNC ( r = 0.423 , p0.05 ) ( r = - 0.304 , p0.05 ) ( r = - 0.287 , p0.05 ) ;
The level of CD80 expression was negatively correlated with hemoglobin and platelet ( r = - 0.441 , p0.05 ) ( r = - 0.464 , p0.05 ) .
There was a negative correlation ( r = - 0.733 , p . 05 ) between the expression level and Th1 / Th2 ( r = - 0.733 , p0.05 ) , which was positively correlated with the number of BMMNC ( r = 0.283 , p0.05 ) ( r = - 0.519 , p0.05 ) ( r = - 0.519 , p0.05 ) ( r = - 0.567 , p0.05 ) .
The level of CD80 expression was negatively correlated with the level of hemoglobin and white blood cells ( r = - 0.262 , p0.05 ) ( r = - 0.31 , p < 0.05 ) . The expression level of CD80 was negatively correlated with leukocyte level ( r = - 0.245 , p0.05 ) .

Conclusion : The quantity of pDC is increased in patients with IRPs , and the quantity is consistent with the change of functional state . As the therapy is effective , it gradually tends to be normal . pDC may play an important role in the pathogenesis of IRPs , and it is possible to be a potential therapeutic target for the disease .

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R392

【参考文献】