Abnormalities of the Bone Marrow Immune Microenvironment in Patients with Prolonged Isolated Thrombocytopenia after Allogeneic Hematopoietic Stem Cell Transplantation
Abnormalities of the Bone Marrow Immune Microenvironment in Patients with Prolonged Isolated Thrombocytopenia after Allogeneic Hematopoietic Stem Cell Transplantation
复制标题
异基因造血干细胞移植后长期孤立性血小板减少症患者骨髓免疫微环境异常
DOI：
10.1016/j.bbmt.2017.02.021
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发表时间：
2017-06-01
影响因子：
4.3
通讯作者：
Kong, Yuan
中科院分区：
文献类型：
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作者：
Song, Yang;Shi, Min-Min;Kong, Yuan
长期孤立性血小板减少症（PT）是同种异体造血干细胞移植（alloo - hsct）后的严重并发症。然而，骨髓免疫微环境异常是否参与PT的发病机制尚不清楚。20例PT患者、40例同种异体造血干细胞移植后移植功能良好（GGF）的匹配患者和20例健康供体（HD）被纳入这项巢式病例对照研究。流式细胞术分析Th1、Th2、Tc1、Tc2、Th17和Treg细胞，用细胞头法和ELISA检测BM血浆中ifn - γ、IL-4、IL-17、IL-6、IL-21和血小板生成素水平。与GGF患者和HD对照组相比，PT患者的Th1和Tc1细胞比例明显更高，导致BM微环境中Th1/Th2和Tc1/Tc2比例更高。此外，在PT患者中观察到Th17的过度极化。BM血浆细胞因子的变化与我们的细胞研究结果一致。这些结果表明，BM微环境中失调的T细胞反应可能在PT的发病机制中发挥重要作用。(C) 2017美国血液和骨髓移植学会。
Prolonged isolated thrombocytopenia (PT) is a serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Whether abnormalities of the bone marrow (BM) immune microenvironment are involved in the pathogenesis of PT remains unknown, however. Twenty patients with PT, 40 matched patients with good graft function (GGF) after allo-HSCT, and 20 healthy donors (HD) were enrolled in this nested case-control study. Th1, Th2, Tc1, Tc2, Th17, and Treg cells were analyzed by flow cytometry, and IFN-gamma, IL-4, IL-17, IL-6, IL-21, and thrombopoietin levels in BM plasma were evaluated with a cytometric bead assay and ELISA. Relative to GGF patients and HD controls, PT patients had significantly higher proportions of Th1 and Tc1 cells, resulting in higher Th1/Th2 and Tc1/Tc2 ratios in the BM microenvironment. In addition, the excessive polarization of Th17 was observed in patients with PT. Changes in BM plasma cytokines were consistent with our cellular findings. These results suggest that dysregulated T cell responses in the BM microenvironment might play an important role in the pathogenesis of PT. (C) 2017 American Society for Blood and Marrow Transplantation.