Porta C, Caporali R, Epis O, Ramaioli I, Invernizzi R, Rovati B, Comolli G, Danova M, Montecucco C
Istituto di Medicina Interna ed Oncologia Medica, Università degli Studi di Pavia e I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Bone Marrow Transplant. 2004 Apr;33(7):721-8. doi: 10.1038/sj.bmt.1704407.
We have evaluated bone marrow morphology, percentage of bone marrow CD34(+) cells, proliferative activity of bone marrow precursors, clonogenic assay (BFU-E and CFU-GM) in short-term bone marrow cultures, and bone marrow cell apoptosis, together with serum TNF-alpha and IL-6, in 16 chronic, refractory RA patients, as well as in five healthy controls. Of 16 RA patients (68.7%), 11 showed a reduced bone marrow cellularity, while it was normal in all the controls. In RA patients, the median percentage of CD34(+) bone marrow cells, the median percentage of proliferating bone marrow myeloid precursors, and the median number of both BFU-E and CFU-GM colonies were significantly lower than observed in the controls. As far as TNF-alpha and IL-6 titers is concerned, the latter did not significantly differ from controls' values, while TNF-alpha titers were significantly lower in healthy controls. Finally, the median apoptotic index of early bone marrow myeloid cells of RA patients was significantly higher compared with controls. These observations may identify the biological risk factors for impaired mobilization and/or engraftment when RA patients are candidates for autologous hematopoietic stem cell grafting.
我们评估了16例慢性难治性类风湿关节炎（RA）患者以及5名健康对照者的骨髓形态、骨髓CD34(+)细胞百分比、骨髓前体细胞的增殖活性、短期骨髓培养中的集落形成试验（BFU-E和CFU-GM）、骨髓细胞凋亡情况，以及血清肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平。16例RA患者中（68.7%），11例骨髓细胞密度降低，而所有对照者的骨髓细胞密度均正常。在RA患者中，CD34(+)骨髓细胞的中位数百分比、增殖的骨髓髓系前体细胞的中位数百分比以及BFU-E和CFU-GM集落的中位数数量均显著低于对照者。就TNF-α和IL-6滴度而言，IL-6滴度与对照者的值无显著差异，而健康对照者的TNF-α滴度显著更低。最后，RA患者早期骨髓髓系细胞的中位数凋亡指数显著高于对照者。这些观察结果可能确定了RA患者作为自体造血干细胞移植候选者时，动员和/或植入受损的生物学危险因素。
