【摘要】 目的检测骨髓增生异常综合征(MDS)患者外周血树突细胞(DC)总量、亚群(pDC 和mDC)比例及其表面协同刺激分子(cD80、CD86和 CD40)表达,探讨 MDS 患者细胞免疫异常的形成机制。方法选取38例 MDS 患者及19名正常对照,采用荧光素单克隆抗体标记法和流式细胞术检测MDS 患者外周血中 Lin1~-HLA-DR~+细胞(DC)、Lin1~-HLA-DR~+CD123~+细胞(pDC)、Linl~-HLA-DR~+CD11c~+细胞(mDC)的数量以及 CD80、CD86和 CD40在 DC 膜上的表达。结果低危 MDS 组、高危MDS 组和正常对照组外周血 DC 总量分别为(33.7±7.0)×10~6/L、(56.3±29.0)×10~6/L 和(12.1±1.4)×10~6/L(P<0.05),pDC 数量分别为(12.6±4.1)×10~6/L、(3.6±1.0)×10~6/L 和(6.6±0.7)×10~6/L(P>0.05),mDC 数量分别为(16.7±6.3)×10~6/L、(28.7±17.6)×10~6/L和(5.5±0.9)×10~6/L(P<0.05)。低危 MDS 组、高危 MDS 组和正常对照组 DC 占外周血单个核细胞(PBMNC)百分比分别为(2.37±0.53)%、(3.58±1.39)%和(0.68±0.08)%(P<0.05),pDC 占 PBMNC 百分比分别为(0.82±0.29)%、(0.31±0.06)%和(0.37±0.04)%(P>0.05),mDC 占 PBMNC 百分比分别为(0.96±0.35)%、(1.51±0.70)%和(0.32±0.05)%(P<0.05)。低危 MDS 组、高危 MDS 组和正常对照组外周血中 CD80~+DC 分别为(30.6±11.8)×10~6/L、(2.3±0.9)×10~6/L 和(2.3±0.6)×10~6/L(P<0.05),CD86~+DC 分别为(25.1±7.4)×10.6/L、(12.4±6.3)×10~6/L 和(6.2±3.2)×10~6/L(P<0.05),CD40~+DC 分别为(2.8±1.0)×10~6/L、(1.5±0.9)×10~6/L 和(3.2±2.3)×10~6/L(P>0.05)。结论 MDS 患者外周血中 DC 数量增多、比例异常;以 mDC 增多为主,pDC 无明显增多;MDS 患者 DC高表达 CD80和 CD86,CD40表达不增高。提示 MDS 患者诱导抗肿瘤细胞免疫的抗原呈递细胞(pDC)数量及功能不足;而与正常造血克隆炎性损伤有关的抗原呈递细胞(mDC)却增多。这可能是导致MDS 患者细胞免疫异常的重要机制之一。更多还原

【Abstract】 Objective To investigate the quantity,subset of dendritic cells(DC)and their costimu- latory molecule expression in peripheral blood(PB)of the patients with myelodysplastic syndromes(MDS). Methods Total DC(Lin1~+HLA-DR~+),myeloid DC(mDC)(Lin1~-HLA-DR~+CD11c~+)and plasma DC (pDC)(Lin1~-HLA-DR~+CD123~+)in fresh PB samples of 38 MDS patients and 19 normal controls were as- sayed by flow cytometry with the monoclonal antibodies.The expressions of costimulatory molecules CD80, CD86 and CD40 on these DCs were also assayed in the same way.Results The number of total DC in PB of low-risk and high-risk MDS patients was significantly higher than that in normal controls[(33.7±7.0)× 10~6/L,(56.3±29.0)×10~6/L vs(12.1±1.4)×10~6/L,respectively](P<0.05),that of mDC in PB of low-risk and high-risk MDS patients was higher than that of normal controls too[(16.7±6.3)×10~6/L, (28.7±17.6)×10~6/L vs(5.5±0.9)×10~6/L](P<0.05),but pDC in low-risk and high-risk MDS pa- tients was not significantly higher than that in normal controls(P>0.05).The percentage of total DC in PB mononuclear cells(PBMNC)of low-risk and high-risk MDS patients[(2.37±0.53)% and(3.58± 1.39)% respectively and that of mDC(0.90±0.35)%,(1.51±0.70)% respectively]were higher than that of normal controls[(0.68±0.08)%,and(0.32±0.05)% respectively](P<0.05),but that of pDC in MDS cases was not higher than that of normal controls(P>0.05).The expressions of CD80 and CD86 be- tween MDS patients and normal controls had significant difference(P<0.05).Conclusions Total DC and mDC were increased significantly in MDS,but pDC did not.The costimulatory molecules(CD80 and CD86) except CD40 expressed higher on the DC of MDS patients.It suggested that the inflammatory injury related APC increased in MDS,but the antitumour immunity related APC did not.What found here might be one of the mechanisms involved in the pathogenesis of MDS.更多还原