Chen Jin, Fu Rong, Li Li-Juan, Liu Hui, Wang Yi-Hao, Wang Hong-Lei, Shao Zong-Hong
Department of Hematology and Oncology, General Hospital, Tianjin Medical University, Tianji, China.
Zhonghua Xue Ye Xue Za Zhi. 2009 Jul;30(7):454-7.
To investigate the variation of bone marrow complement level in cytopenia patients with positive BMMNC-Coombs test (CBCPC), and probe the role of complement in destroying hematopoietic cells of CBCPC patients.
One hundred and twenty-four patients with CBCPC and twenty-three healthy donors as controls were enrolled in this study. The levels of CH50, C3, C4, C5b-9 were tested with ELISA. The auto-antibodies on bone marrow hematopoietic cells (BMHC) were examined with flow cytometry.
The level of C5b-9 in bone marrow (BM) of untreated CBCPC patients [(119.8+/-54.0) microg/L] was significantly higher than that of recovered patients [(100.7+/-33.4) microg/L] or normal controls [(93.9+/-28.8) microg/L] (P<0.05). The levels of CH50 in BM of untreated or recovered CBCPC patients [(33.3+/-11.5) kU/L, (30.8+/-10.3) kU/L] were significantly higher than that of normal controls [(24.1+/-6.4) kU/L] (P<0.05). The level of C3 in BM of untreated or recovered CBCPC patients [(4.9+/-2.2) mg/L], (5.0+/-3.5) mg/L] was significantly lower than that of normal controls [(7.0+/-5.6) mg/L] (P<0.05). The level of complement in peripheral blood was consistent with that in BM. CH50 in BM of CBCPC patients was negatively correlated with their C3 (r=-0.303, P=.0007) and positively correlated with their C5b-9 (r=0.241, P=0.003) levels. The level of C5b-9 in BM of CBCPC patients was higher in the BMHC-IgM positive group [(117.6+/-55.7) microg/L] than in the BMHC- IgM negative group [(99.2+/-26.2) microg/L] (P<0.05). The positive rate of CD34(+)-IgG or CD34(+)-IgM of CBCPC patients was positively correlated with their C5b-9 level (r=0.593, P=0.000, r=0.326, P=0.049). The reticulocyte percentage (r=0.421, P=0.000) and serum indirect bilirubin level (r=0.230, P=0.032) of CBCPC patients were positively correlated with their CH50 level.
The hematocytopenia of CBCPC patients might be related to the hematopoietic cells destruction caused by auto-antibody activated complements.
探讨骨髓单个核细胞抗人球蛋白试验（BMMNC - Coombs试验）阳性的血细胞减少症患者（CBCPC）骨髓补体水平的变化，并探讨补体在破坏CBCPC患者造血细胞中的作用。
本研究纳入124例CBCPC患者和23例健康供者作为对照。采用酶联免疫吸附测定法（ELISA）检测CH50、C3、C4、C5b - 9水平。采用流式细胞术检测骨髓造血细胞（BMHC）上的自身抗体。
未经治疗的CBCPC患者骨髓中C5b - 9水平[（119.8±54.0）μg/L]显著高于恢复患者[（100.7±33.4）μg/L]或正常对照[（93.9±28.8）μg/L]（P<0.05）。未经治疗或恢复的CBCPC患者骨髓中CH50水平[（33.3±11.5）kU/L，（30.8±10.3）kU/L]显著高于正常对照[（24.1±6.4）kU/L]（P<0.05）。未经治疗或恢复的CBCPC患者骨髓中C3水平[（4.9±2.2）mg/L，（5.0±3.5）mg/L]显著低于正常对照[（7.0±5.6）mg/L]（P<0.05）。外周血补体水平与骨髓一致。CBCPC患者骨髓中CH50与C3呈负相关（r = - 0.303，P = 0.0007），与C5b - 9呈正相关（r = 0.241，P = 0.003）。CBCPC患者骨髓中BMHC - IgM阳性组的C5b - 9水平[（117.6±55.7）μg/L]高于BMHC - IgM阴性组[（99.2±26.2）μg/L]（P<0.05）。CBCPC患者CD34(+) - IgG或CD34(+) - IgM阳性率与其C5b - 9水平呈正相关（r = 0.593，P = 0.000，r = 0.326，P = 0.049）。CBCPC患者的网织红细胞百分比（r = 0.421，P = 0.000）和血清间接胆红素水平（r = 0.230，P = 0.032）与其CH50水平呈正相关。
CBCPC患者血细胞减少可能与自身抗体激活补体导致造血细胞破坏有关。
