Wang T, Hao S F, Fu R, Wang H Q, Shao Z H
Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhonghua Yi Xue Za Zhi. 2017 May 16;97(18):1406-1410. doi: 10.3760/cma.j.issn.0376-2491.2017.18.011.
To confirm the presence of erythropoietin receptor (EPOR) antibody in patients with immune-related pancytopenia (IRP) and to evaluate the significance of EPOR in IRP. A total of 59 newly-diagnosed IRP patients, 62 patients with IRP in remission, 14 patients with aplastic anemia (AA), 15 patients with myelodysplastic syndromes (MDS) and 33 healthy controls were enrolled in this study from January 2013 to June 2015 in Tianjin Medical University General Hospital. The anti-EPOR antibody was detected by enzyme-linked immunosorbent assay(ELISA). The expression of EPOR mRNA was detected by quantitative real-time PCR (qRT-PCR). The correlation between the data and the clinical indicators of patients was analyzed. The levels of anti-EPOR antibodies were higher in the newly-diagnosed IRP patients than in the remission IRP group, AA group, MDS group and controls(0.84±0.39 vs 0.46±0.25, 0.49±0.25, 0.50±0.25, 0.53±0.14, all <0.05). The expression of EPOR- mRNA was up-regulated in the newly-diagnosed IRP group than in the remission IRP group and the controls. The positive rate of EPOR antibody was significantly elevated in the patients with low hemoglobin level (<100 g/L), positive GlycoA antibody, or low complement C3 (all <0.05). Anti-EPOR antibody was significantly decreased in the IRP patients responding to immunosuppressive therapy. Anti-EPOR autoantibody is present in patients with IRP. Detection of anti-EPOR antibody has important clinical value in the diagnosis, differential diagnosis and treatment effect evaluation of IRP.
确认免疫相关性全血细胞减少症(IRP)患者中促红细胞生成素受体(EPOR)抗体的存在,并评估EPOR在IRP中的意义。2013年1月至2015年6月,天津医科大学总医院共纳入59例新诊断的IRP患者、62例缓解期IRP患者、14例再生障碍性贫血(AA)患者、15例骨髓增生异常综合征(MDS)患者和33名健康对照者。采用酶联免疫吸附测定(ELISA)检测抗EPOR抗体。采用定量实时聚合酶链反应(qRT-PCR)检测EPOR mRNA的表达。分析数据与患者临床指标之间的相关性。新诊断的IRP患者抗EPOR抗体水平高于缓解期IRP组、AA组、MDS组和对照组(0.84±0.39 vs 0.46±0.25、0.49±0.25、0.50±0.25、0.53±0.14,均P<0.05)。新诊断的IRP组EPOR-mRNA的表达高于缓解期IRP组和对照组。血红蛋白水平低(<100 g/L)、糖基化白蛋白(GlycoA)抗体阳性或补体C3低的患者中,EPOR抗体阳性率显著升高(均P<0.05)。对免疫抑制治疗有反应的IRP患者抗EPOR抗体显著降低。IRP患者存在抗EPOR自身抗体。检测抗EPOR抗体对IRP的诊断、鉴别诊断及治疗效果评估具有重要临床价值。