Kuroki M, Okayama A, Nakamura S, Sasaki T, Murai K, Shiba R, Shinohara M, Tsubouchi H
Department of Internal Medicine II, Miyazaki Medical College, Miyazaki, Japan.
Ann Rheum Dis. 2002 Dec;61(12):1041-6. doi: 10.1136/ard.61.12.1041.
A possible relation between maternal-fetal microchimerism and autoimmune diseases with some similarities to chronic graft versus host disease (cGVHD) has been reported.
To investigate whether cells with male DNA exist in female patients with Sjögren's syndrome (SS) as SS has clinical features similar to those of cGVHD.
DNA was extracted from 27 samples of peripheral blood mononuclear cells (PBMC), 42 biopsy samples of labial salivary glands (LSG), and nine samples of bronchoalveolar lavage fluid (BALF) cells from 56 female patients with SS. The presence of male DNA was determined by nested polymerase chain reaction (PCR) and by fluorescence in situ hybridisation (FISH).
Among 56 female patients with SS, 42 patients had at least one male child. Among those 42 patients, none of the 22 PBMC but 10/28 (36%) LSG samples tested positive by PCR for the Y chromosome-specific sequence (p=0.0013). The Y chromosome-specific sequence was not detected in the samples of LSG in 10 patients without SS. In the BALF samples 2/9 (22%) patients with SS tested positive by PCR. Cells containing the Y chromosome were shown to exist in all the LSG specimens from three female patients with SS by FISH.
Maternal-fetal microchimerism was shown for the first time to exist in the salivary glands and lungs of female patients with SS in this study. The presence of non-host cells in the inflammatory lesions but not in the peripheral blood suggests a possible role for maternal-fetal microchimerism in the pathogenesis of SS.
有报道称母胎微嵌合体与自身免疫性疾病之间可能存在关联,这些自身免疫性疾病与慢性移植物抗宿主病(cGVHD)有一些相似之处。
由于干燥综合征(SS)具有与cGVHD相似的临床特征,研究患有SS的女性患者体内是否存在携带男性DNA的细胞。
从56例患有SS的女性患者的27份外周血单个核细胞(PBMC)样本、42份唇唾液腺(LSG)活检样本和9份支气管肺泡灌洗(BALF)细胞样本中提取DNA。通过巢式聚合酶链反应(PCR)和荧光原位杂交(FISH)检测男性DNA的存在。
在56例患有SS的女性患者中,42例患者至少有一个男性子女。在这42例患者中,22份PBMC样本经PCR检测Y染色体特异性序列均为阴性,但28份LSG样本中有10份(36%)呈阳性(p = 0.0013)。10例无SS患者的LSG样本中未检测到Y染色体特异性序列。在BALF样本中,9例患有SS的患者中有2例(22%)经PCR检测呈阳性。通过FISH显示,3例患有SS的女性患者的所有LSG标本中均存在含有Y染色体的细胞。
本研究首次表明患有SS的女性患者的唾液腺和肺中存在母胎微嵌合体。炎症病变而非外周血中存在非宿主细胞,提示母胎微嵌合体可能在SS的发病机制中起作用。