Abnormal Myeloid Lineage Cells Expressing the Difucosyl or Trifucosyl Type 2 Chain in Bone Marrow Cells of Patinets with Severe Rheumatoid Arthritis.

类风湿关节炎(RA)患者的髂骨骨髓单个核细胞绝对数是非RA对照组的3倍。相反，骨痂骨髓或外周血中的单个核细胞未见明显增加。在淋巴细胞亚群中，RA患者髂骨骨髓中的HLA-DR+CD8+细胞占全部CD8细胞的百分比明显高于非RA对照组。重度类风湿关节炎患者的异常髓系细胞(CD14+CD15+细胞)主要集中在髂骨骨髓中，而在胫骨骨骺中较少。IL-1β和GM-CSF促进这些异常髓系细胞的产生，而T淋巴细胞则抑制这些异常髓系细胞的产生。这些异常的髓系细胞被证实分化为多形核白细胞。在严重类风湿关节炎患者中，关节周围骨骺骨髓单个核细胞和中性粒细胞裂解产物中IL-1α和IL-1β水平较高。IL-6和IL-8在髂骨骨髓血清中显著升高，而在胫骨骨髓和外周血中水平较低。髂骨骨髓血清中IL-6、IL-8水平与滑膜增生程度密切相关。从骨髓和滑膜建立了基质细胞(护理系)，这些细胞系具有更强的支持前B细胞系和维持异常髓样细胞的能力。

The absolute number of mononuclear cells in the iliac bone marrow was incresed by 3-fold in the rheumatoid arthritis (RA) patients compared with non-RA controls. In contrast, no significant increase of MNC was abserved in the epiphyseal bone marrow or peripheral blood. In lymphocyte subsets, the percentage of HLA-DR+CD8+cells to all CD8 cells in the iliac bone marrow increased significantly in the RA patients compared with the non-RA controls. Abnormal myeloid cells (CD14+CD15+cells) , specific to severe RA,were found to be more concentrated in the iliac bone marrow than in the tibial epiphyseal bone marrow. The production of these abnormal myeloid cells was enhanced by IL-1beta and GM-CSF,but inhibited by T lymphocytes. These abnormal myeloid cells were confirmed to differentiated to polymorphonuclear leukocytes. In patients with severe disease of RA, high levels of IL-1alpha and IL-1beta were found in the cell lysates of MNC and PMN in the epiphyseal bone marrow adjacent to affected joints. Markedly elevated levels of IL-6 and IL-8 were detected in iliac bone marrow serum, and much lower levels were found in the tibial bone marrow and peripheral blood serum. The levels of IL-6 and IL-8 in iliac bone marrow serum showed a close relationship to the extent of synovial proliferation. Stromal cell (nurse cell) line were established from both bone marrow and synovium.These cell lines were shown to have an enhanced ability to support the pre-B-cell lines and to maintain abnormal myeliod cells.