Chen Chun, Wei Jing, Li Ying-Fei, Huang Shao-Liang, Fang Jian-Pei, Zhou Dun-Hua, Xue Hong-Man, Huang Ke
Department of Pediatrics, The Second Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Oct;16(5):1091-5.
This study was aimed to investigate the characteristics of lymphocyte immune abnormality in children idiopathic aplastic anemia (IAA) in order to explore the immune pathogenesis of childhood IAA. The phenotypes of lymphocytes, the ratios of Th1/Th2 and Tc1/Tc2, the levels of CD25(+) and CD4(+)CD25(+) T lymphocytes in peripheral blood of IAA patients were measured at the onset of disease by flow cytometry and were compared with that in normal controls. The influences of those immunological indicators on prognosis of IAA were also analyzed. The results showed that there were 40 cases of severe aplastic anemia (SAA) and 12 cases of mild aplastic anemia (MAA). The levels of CD3(+) CD8(+) T cells in SAA group and MAA group were significantly higher than those in controls (p < 0.05). The levels of CD3(+) and CD3(+) CD4(+) T cells in MAA group were lower than that in SAA group (p < 0.05), but there were no difference was compared with control group. No differences of the levels of CD3(-)CD19(+) T cells were between the both SAA and MAA groups and the control group. The levels of CD3(-)CD56(+) T cells in SAA group and MAA groups were lower significantly than that in control group. As compared to control group, the levels of Th1 and Tc1 in SAA group and MAA groups increased significantly (p < 0.05), and the ratios of Th1/Th2 and Tc1/Tc2 in SAA group and MAA groups increased significantly (p < 0.05). The level of Th2 increased in SAA group. As compared to MAA group, the levels of Th1 and Tc1 and the ratios of Th1/Th2 and Tc1/Tc2 in SAA group increased significantly (p < 0.05). The levels of CD25(+) T lymphocyte in SAA group and MAA group increased significantly (p < 0.05), and were higher than that in normal controls, but levels of CD4(+)CD25(+) T lymphocyte and ratio of CD4(+)CD25(+)/CD4(+) in SAA group and MAA group had no significant difference. It is concluded that the abnormal lymphocyte immune function exist in the onset of childhood IAA. The polarization of Th1/Th2 and Tc1/Tc2 shifts to Th1 and Tc1 cells. These changes closely relate to severity of the disease. There is high level of CD25(+) T lymphocyte in children IAA. These changes reveal that abnormality of immune function plays an important role at the onset of childhood idiopathic aplastic anemia.
本研究旨在探讨儿童特发性再生障碍性贫血（IAA）淋巴细胞免疫异常的特点，以探索儿童IAA的免疫发病机制。采用流式细胞术检测IAA患者发病时外周血淋巴细胞表型、Th1/Th2及Tc1/Tc2比值、CD25(+)和CD4(+)CD25(+)T淋巴细胞水平，并与正常对照进行比较。分析这些免疫指标对IAA预后的影响。结果显示，重型再生障碍性贫血（SAA）40例，轻型再生障碍性贫血（MAA）12例。SAA组和MAA组CD3(+)CD8(+)T细胞水平显著高于对照组（p<0.05）。MAA组CD3(+)和CD3(+)CD4(+)T细胞水平低于SAA组（p<0.05），但与对照组比较差异无统计学意义。SAA组和MAA组与对照组CD3(-)CD19(+)T细胞水平差异无统计学意义。SAA组和MAA组CD3(-)CD56(+)T细胞水平显著低于对照组。与对照组比较，SAA组和MAA组Th1和Tc1水平显著升高（p<0.05），Th1/Th2及Tc1/Tc2比值显著升高（p<0.05）。SAA组Th2水平升高。与MAA组比较，SAA组Th1、Tc1水平及Th1/Th2、Tc1/Tc2比值显著升高（p<0.05）。SAA组和MAA组CD25(+)T淋巴细胞水平显著升高（p<0.05），高于正常对照组，但SAA组和MAA组CD4(+)CD25(+)T淋巴细胞水平及CD4(+)CD25(+)/CD4(+)比值差异无统计学意义。结论：儿童IAA发病时存在淋巴细胞免疫功能异常，Th1/Th2及Tc1/Tc2极化向Th1和Tc1细胞偏移，这些变化与疾病严重程度密切相关。儿童IAA患者CD25(+)T淋巴细胞水平升高。这些变化提示免疫功能异常在儿童特发性再生障碍性贫血发病中起重要作用。
