Department of Clinical Laboratory Science, Graduate School of Medical Science, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Br J Haematol. 2024 Feb;204(2):623-627. doi: 10.1111/bjh.19219. Epub 2023 Nov 27.
The mechanisms underlying hepatitis-associated aplastic anaemia (HAAA) that occurs several weeks after the development of acute hepatitis are unknown. A 20-year-old male developed HAAA following living-donor liver transplantation for fulminant hepatitis. The patient's leucocytes lacked HLA-class I due to loss of heterozygosity in the short arm of chromosome 6p (6pLOH). Interestingly, the patient's liver cells resected during the transplantation also exhibited 6pLOH that affected the same HLA haplotype as the leucocytes, suggesting that CD8 T cells recognizing antigens presented by specific HLA molecules on liver cells may have attacked the haematopoietic stem cells of the patient, leading to the HAAA development.
肝炎相关性再生障碍性贫血（HAAA）发生于急性肝炎后数周，其发病机制尚不清楚。一名 20 岁男性因暴发性肝炎接受活体供肝肝移植后发生 HAAA。由于 6 号染色体短臂（6pLOH）杂合性丢失，该患者白细胞缺乏 HLA-I 类分子。有趣的是，移植时切除的患者肝脏细胞也存在影响与白细胞相同 HLA 单倍型的 6pLOH，提示识别肝细胞上特定 HLA 分子所呈递抗原的 CD8 T 细胞可能攻击了患者的造血干细胞，导致 HAAA 的发生。
