Barakos Georgios Petros, Hatzimichael Eleftheria
First Department of Internal Medicine, General Hospital of Piraeus "Tzaneio", 18536 Piraeus, Greece.
Department of Haematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece.
Diseases. 2022 Jun 10;10(2):33. doi: 10.3390/diseases10020033.
Bone marrow, besides the known functions of hematopoiesis, is an active organ of the immune system, functioning as a sanctuary for several mature immune cells. Moreover, evidence suggests that hematopoietic stem cells (the bone marrow's functional unit) are capable of directly sensing and responding to an array of exogenous stimuli. This chronic immune stimulation is harmful to normal hematopoietic stem cells, while essential for the propagation of myeloid diseases, which show a dysregulated immune microenvironment. The bone marrow microenvironment in myelodysplastic syndromes (MDS) is characterized by chronic inflammatory activity and immune dysfunction, that drive excessive cellular death and through immune evasion assist in cancer cell expansion. Acute myeloid leukemia (AML) is another example of immune response failure, with features that augment immune evasion and suppression. In this review, we will outline some of the functions of the bone marrow with immunological significance and describe the alterations in the immune landscape of MDS and AML that drive disease progression.
骨髓，除了已知的造血功能外，还是免疫系统的一个活跃器官，作为多种成熟免疫细胞的庇护所发挥作用。此外，有证据表明造血干细胞（骨髓的功能单位）能够直接感知并对外源性刺激作出一系列反应。这种慢性免疫刺激对正常造血干细胞有害，而对骨髓疾病的传播至关重要，骨髓疾病表现出免疫微环境失调。骨髓增生异常综合征（MDS）中的骨髓微环境以慢性炎症活动和免疫功能障碍为特征，这会导致细胞过度死亡，并通过免疫逃逸协助癌细胞扩张。急性髓系白血病（AML）是免疫反应失败的另一个例子，其特征是增强免疫逃逸和免疫抑制。在这篇综述中，我们将概述骨髓具有免疫学意义的一些功能，并描述驱动MDS和AML疾病进展的免疫格局变化。
