Al-Mufti R, Hambley H, Farzaneh F, Nicolaides K H
Harris Birthright Research Centre For Fetal Medicine, King's College Trust School of Medicine, Denmark Hill, London SE5 8RX, England.
Haematologica. 2001 Dec;86(12):1270-6.
To determine whether there is a delay or reversal in switch mechanisms from embryonic (e and z) to fetal (g) hemoglobins accompanying the erythroblastosis of anemic fetuses and whether an increased erythroblast count in fetal blood is associated with an increase in feto-maternal cell trafficking.
Fetal and maternal blood samples were obtained from 10 cases with rhesus isoimmunization and 2 cases with maternal Parvo-B19 virus at 19-33 weeks' gestation. Blood samples were also taken as controls from 61 fetuses and 86 mothers. Fetal erythroblasts were isolated by triple density gradient centrifugation and magnetic cell sorting with CD71 antibody. Fluorescent antibodies were used to immuno-stain for zeta (z), epsilon (e) and gamma (g) hemoglobin chains. In the maternal samples, fluorescence in situ hybridization (FISH) for X and Y chromosomes was also carried out to confirm the presence and proportion of the enriched fetal cells from maternal blood.
In both fetal and maternal blood the percentage of erythroblasts positive for g-globin chain was significantly higher in the anemic fetuses compared to the controls (fetal blood, p<0.001, R=0.91; maternal blood, p<0.001, R=0.56), but there was no significant difference in expression of the e and z-chains. The percentage of cells with Y-signals was also higher in the maternal samples of anemic fetuses compared to normal controls (p<0.001, R=0.56).
These findings suggest that the erythroblastosis of anemic fetuses is not accompanied by a delay or a reversal in switch from embryonic to fetal hemoglobin chains. Severe fetal anemia is associated with an increase in feto-maternal cell trafficking.
确定贫血胎儿的成红细胞增多症是否伴有从胚胎型（e和z）血红蛋白向胎儿型（g）血红蛋白转换机制的延迟或逆转，以及胎儿血液中幼红细胞计数的增加是否与母胎细胞转运增加相关。
在妊娠19 - 33周时，从10例恒河猴血型免疫病例和2例感染细小病毒B19的孕妇中获取胎儿和母体血样。还从61例胎儿和86例母亲中采集血样作为对照。通过三重密度梯度离心和用CD71抗体进行磁性细胞分选分离胎儿幼红细胞。使用荧光抗体对ζ（z）、ε（e）和γ（g）血红蛋白链进行免疫染色。在母体样本中，还进行了X和Y染色体的荧光原位杂交（FISH），以确认母体血液中富集的胎儿细胞的存在和比例。
与对照组相比，贫血胎儿的胎儿和母体血液中γ - 珠蛋白链阳性的幼红细胞百分比显著更高（胎儿血液，p<0.001，R = 0.91；母体血液，p<0.001，R = 0.56），但e链和z链的表达没有显著差异。与正常对照组相比，贫血胎儿母体样本中具有Y信号的细胞百分比也更高（p<0.001，R = 0.56）。
这些发现表明，贫血胎儿的成红细胞增多症并不伴有从胚胎血红蛋白链向胎儿血红蛋白链转换的延迟或逆转。严重胎儿贫血与母胎细胞转运增加相关。
