Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
J Vet Intern Med. 2021 Nov;35(6):2713-2721. doi: 10.1111/jvim.16278. Epub 2021 Oct 30.
Although precursor-targeted immune-mediated anemia (PIMA) is thought to be caused by immune targeting of erythroid precursors (nucleated RBCs, nRBCs), its pathogenesis is unknown. Immunoglobulin G (IgG) or phosphatidylserine (PS) may promote nRBC destruction in PIMA.
Dogs with PIMA have increased nRBC IgG and PS, and dogs with immune-mediated hemolytic anemia (IMHA) have increased RBC PS compared to healthy dogs.
Blood from 20 healthy dogs and from dogs with IMHA (11) or other (non-IMHA) conditions (9), and marrow aspirates with or without blood from 10 healthy dogs and from dogs with PIMA (17) or other (non-IMHA, non-PIMA) conditions (7).
Marrow nRBC stages were separated by density gradient. Flow cytometry was used to assess the percentage of RBCs or nRBCs with increased IgG or PS.
Red blood cell (RBC) IgG positivity was increased in 9/11 IMHA dogs and 0/9 non-IMHA dogs. Red blood cell PS positivity was increased in 10/11 IMHA dogs and 2/9 non-IMHA dogs. Five of 17 PIMA dogs had increased nRBC IgG positivity in mid- or late-stage fractions, whereas all 7 non-PIMA dogs were negative. Mid- and late-stage erythroid precursor PS was significantly higher in PIMA dogs compared to healthy dogs. Five of 14 PIMA dogs had increased RBC IgG positivity.
Immunoglobulin G and PS may promote destruction of nRBCs in PIMA dogs; PS may promote destruction of RBCs in IMHA dogs.
尽管前驱靶向免疫介导性贫血（PIMA）被认为是由红细胞前体（有核红细胞，nRBC）的免疫靶向引起的，但它的发病机制尚不清楚。免疫球蛋白 G（IgG）或磷脂酰丝氨酸（PS）可能会促进 PIMA 中的 nRBC 破坏。
患有 PIMA 的狗的 nRBC IgG 和 PS 增加，而患有免疫介导性溶血性贫血（IMHA）的狗的 RBC PS 比健康狗增加。
来自 20 只健康狗和患有 IMHA（11 只）或其他（非 IMHA）疾病（9 只）的狗的血液，以及来自 10 只健康狗和患有 PIMA（17 只）或其他（非 IMHA，非 PIMA）疾病（7 只）的狗的骨髓抽吸物，有或没有血液。
通过密度梯度分离骨髓中的 nRBC 阶段。使用流式细胞术评估 RBC 或 nRBC 中 IgG 或 PS 增加的百分比。
9/11 只 IMHA 狗的红细胞（RBC）IgG 阳性增加，而 9/9 只非 IMHA 狗的 RBC 阴性。10/11 只 IMHA 狗的 RBC PS 阳性增加，而 2/9 只非 IMHA 狗的 RBC PS 阴性。在 17 只 PIMA 狗中，有 5 只在中晚期 nRBC 分数中 IgG 阳性增加，而所有 7 只非 PIMA 狗均为阴性。与健康狗相比，PIMA 狗的中晚期红系前体 PS 明显更高。在 14 只 PIMA 狗中，有 5 只 RBC IgG 阳性增加。
IgG 和 PS 可能会促进 PIMA 狗中 nRBC 的破坏；PS 可能会促进 IMHA 狗中 RBC 的破坏。
