Olwill Shane A, McGlynn Hugh, Gilmore William S, Alexander H Denis
School of Biomedical Sciences, University of Ulster, Coleraine BT52 1SA Northern Ireland, UK.
Thromb Res. 2005;115(1-2):109-14. doi: 10.1016/j.thromres.2004.07.014.
Acute promyelocytic leukaemia (APL) (M3) is associated with both a characteristic t(15;17) and severe bleeding diathesis caused by disseminated intravascular coagulation (DIC) and/or hyperfibrinolysis. It has been suggested that annexin II, a coreceptor for tissue plasminogen activator (t-PA) and plasminogen (PLG), is overexpressed on the surface of promyelocytes, leading to an increased fibrinolytic potential.
This study examined the level of annexin II cell surface and mRNA expression in a range of acute myeloid leukaemia (AML) cell lines. The evidence that annexin II levels are higher in APL would lend support to the hypothesis that the bleeding disorder seen in APL is caused by hyperfibrinolysis.
Cell surface annexin II was found to be expressed at higher levels on NB4 (promyelocytic) cells than on either KG1a (early myeloid) or HL60 (myelocytic) cells. However, even higher levels were found on U937 and MM6 (histo-monocytic) and HEL (erythroid) cells (p<0.01). MM6 cells showed a threefold increase in annexin II mRNA compared to any of the other cell lines.
These findings do not fully support the concept of the coagulopathy associated with APL being caused by hyperfibrinolysis alone. Further investigations are required to identify the significance of annexin II expression and regulation in leukaemia.
急性早幼粒细胞白血病(APL,M3型)与特征性的t(15;17)以及由弥散性血管内凝血(DIC)和/或纤维蛋白溶解亢进引起的严重出血素质相关。有人提出,膜联蛋白II作为组织纤溶酶原激活物(t-PA)和纤溶酶原(PLG)的共受体,在早幼粒细胞表面过度表达,导致纤溶潜能增加。
本研究检测了一系列急性髓系白血病(AML)细胞系中膜联蛋白II的细胞表面水平和mRNA表达。APL中膜联蛋白II水平较高的证据将支持APL中所见出血性疾病是由纤维蛋白溶解亢进引起的这一假说。
发现NB4(早幼粒细胞)细胞表面膜联蛋白II的表达水平高于KG1a(早期髓系)或HL60(髓系)细胞。然而,在U937和MM6(组织单核细胞)以及HEL(红系)细胞上发现了更高的水平(p<0.01)。与其他任何细胞系相比,MM6细胞的膜联蛋白II mRNA增加了两倍。
这些发现并不完全支持APL相关凝血病仅由纤维蛋白溶解亢进引起的概念。需要进一步研究以确定膜联蛋白II在白血病中表达和调控的意义。