Hans Chander, Sharma Prashant, Saini Rahul, Sachdeva M U S, Khadwal Alka Rani, Bose Parveen Lata, Das Reena
Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Microsc Ultrastruct. 2023 Feb 7;13(1):1-7. doi: 10.4103/jmau.jmau_97_22. eCollection 2025 Jan-Mar.
Erythrocytic damage and death in response to physiochemical, infectious, metabolic, and pharmacological insults have been extensively studied in several diseases. Their relationship with erythroid precursors' apoptosis and morphological dysplasia, however, remains largely unexplored, despite several shared triggers and pathogenetic mechanisms.
We compared peripheral blood phosphatidylserine (PS) exposure and calcium influx in 53 patients with early and late apoptosis of CD71 + ve marrow erythroblasts using flow cytometry. Flow cytometric results were then correlated with dyserythropoiesis in the bone marrow as scored by experienced morphologists.
Median patient age was 32 years (range: 1-75 years); 38 (72%) had hemoglobin (Hb) ≤11.0 g%. Patients overall had significantly higher Annexin V binding (PS exposure) and Fluo-3AM signal (calcium influx) vis-à-vis 20 healthy controls. Dyserythropoiesis on morphological evaluation correlated significantly with PS exposure ( = 0.618, = 0.014) and Fluo-3AM binding ( = 0.002). Patients with dyserythropoiesis had significantly higher apoptosis compared to those without dyserythropoiesis ( = 0.006). In the peripheral blood, Annexin V binding and Fluo-3AM fluorescence correlated strongly with each other ( = 0.885, < 0.001). PS exposure and Ca influx were increased in 64% of cases. These patients had significantly lower Hbs and reticulocyte counts and increased red cell distribution widths and circulating nucleated red blood cell numbers.
This is the first study to compare and demonstrate links between dyserythropoiesis, peripheral blood eryptosis, and erythroblastic apoptosis. Eryptosis and apoptosis' interrelationships in patients with diverse hematological disorders link the marrow environment to peripheral blood.
在多种疾病中，针对物理化学、感染、代谢和药理学损伤所产生的红细胞损伤与死亡已得到广泛研究。然而，尽管存在一些共同的触发因素和发病机制，但它们与红系前体细胞凋亡及形态发育异常之间的关系在很大程度上仍未得到探索。
我们使用流式细胞术比较了53例CD71 + 阳性骨髓有核红细胞早期和晚期凋亡患者外周血中磷脂酰丝氨酸（PS）暴露和钙内流情况。然后将流式细胞术结果与经验丰富的形态学家对骨髓中红细胞生成异常的评分进行关联分析。
患者中位年龄为32岁（范围：1 - 75岁）；38例（72%）血红蛋白（Hb）≤11.0 g%。总体而言，与20名健康对照相比，患者的膜联蛋白V结合（PS暴露）和Fluo - 3AM信号（钙内流）显著更高。形态学评估的红细胞生成异常与PS暴露（r = 0.618，P = 0.014）和Fluo - 3AM结合（r = 0.002）显著相关。与无红细胞生成异常的患者相比，有红细胞生成异常的患者凋亡显著更高（P = 0.006）。在外周血中，膜联蛋白V结合和Fluo - 3AM荧光彼此高度相关（r = 0.885，P < 0.001）。64%的病例中PS暴露和钙内流增加。这些患者的Hb和网织红细胞计数显著更低，红细胞分布宽度和循环有核红细胞数量增加。
这是第一项比较并证明红细胞生成异常、外周血红细胞凋亡和有核红细胞凋亡之间联系的研究。不同血液系统疾病患者中红细胞凋亡和有核红细胞凋亡的相互关系将骨髓环境与外周血联系起来。
