Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli Federico II, Napoli, Italy.
Br J Haematol. 2010 Jan;148(1):90-8. doi: 10.1111/j.1365-2141.2009.07921.x. Epub 2009 Sep 29.
The myelodysplastic syndromes (MDS) are clonal disorders characterised by ineffective haematopoiesis with high risk of leukaemia progression. The relevance of immune-dysregulation for emergence, dominance and progression of dysplastic clones has been suggested, but valuable criteria to obtain insight into these connections are lacking. This study showed significant increase of CD8 lymphocytes and mature B cells in the bone marrow (BM) compared to peripheral blood (PB) of low risk MDS patients. Different BM levels of Regulatory T cells (Treg) identified two sub-groups in these patients; only the sub-group with lower Treg percentage showed BM recruitment of CD8 lymphocytes. Different levels of CD54 on BM CD8 cells revealed two sub-groups of Intermediate-1 (Int-1) patients. The sub-group with higher CD54 expression on BM CD8 showed high levels of this molecule also on CD4 cells. BM recruitment of CD8 lymphocytes in the low risk group and/or the presence of high CD54 expression on BM CD8 in Int-1 patients were associated with more pronounced dyserythropoiesis and erythropoietin treatment. Our data shed light on the involvement of immune-mediated mechanisms in Low and Int-1 risk MDS patients and suggest that BM versus PB levels of immune effectors could represent useful criteria for a more homogeneous grouping of MDS patients.
骨髓增生异常综合征（MDS）是一种克隆性疾病，其特征为无效造血，白血病进展风险高。免疫失调与病态克隆的出现、优势和进展有关，但缺乏深入了解这些联系的有价值标准。本研究表明，低危 MDS 患者的骨髓（BM）中 CD8 淋巴细胞和成熟 B 细胞明显高于外周血（PB）。调节性 T 细胞（Treg）的不同 BM 水平在这些患者中确定了两个亚组；只有 Treg 百分比较低的亚组显示 BM 中有 CD8 淋巴细胞募集。BM CD8 细胞上不同水平的 CD54 揭示了中间-1 型（Int-1）患者的两个亚组。BM CD8 上 CD54 表达较高的亚组在 CD4 细胞上也表现出高水平的该分子。低危组 BM 中 CD8 淋巴细胞的募集和/或 Int-1 患者 BM CD8 上高 CD54 表达与更明显的红细胞生成异常和促红细胞生成素治疗有关。我们的数据阐明了免疫介导的机制在低危和 Int-1 风险 MDS 患者中的作用，并表明 BM 与 PB 免疫效应物水平可能代表 MDS 患者更同质分组的有用标准。
