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目的:初步探讨再生障碍性贫血(AA)患者外周血CD4+CD25+Foxp3+调节性T细胞(Treg)的表达及临床意义;探讨临床使用异体骨髓间充质干细胞(MSC)治疗对CD4+CD25+Foxp3+Treg表达的影响。方法:(1)流式细胞仪检测13例重型再生障碍性贫血(SAA),17例慢性再生障碍性贫血(CAA)及10例健康对照者外周血CD4+CD25+Foxp3+Treg表达;(2)检测7例AA患者MSC治疗前后外周血CD4+CD25+Foxp3+Treg表达。结果:(1)AA患者外周血CD4+CD25+Foxp3+Treg表达明显低于健康对照者(P<0.01);(2)SAA患者CD4+CD25+Foxp3+Treg表达较CAA者低(P<0.05);(3)MSC治疗后AA患者外周血CD4+CD25+Foxp3+Treg表达升高(P<0.05)。结论:(1)AA患者存在外周血CD4+CD25+Foxp3+Treg表达减低,其表达异常可能参与AA的发病;(2)CD4+CD25+Foxp3+Treg表达在SAA患者更低,提示其表达水平可能可以作为判断AA病情轻重的指标;(3)MSC治疗可上调AA患者CD4+CD25+Foxp3+Treg表达,为MSC纠正AA患者的免疫异常提供了临床依据。
Objective: To investigate the expression and clinical significance of CD4 + CD25 + Foxp3 + regulatory T cells (Tregs) in peripheral blood of patients with aplastic anemia (AA) and explore the clinical significance of using allogeneic bone marrow mesenchymal stem cells (MSC) Foxp3 + Treg expression. Methods: (1) Flow cytometry was used to detect the expression of CD4 + CD25 + Foxp3 + Treg in peripheral blood of 13 cases of severe aplastic anemia (SAA), 17 cases of chronic aplastic anemia (CAA) and 10 healthy controls. ) Was used to detect the expression of CD4 + CD25 + Foxp3 + Treg in peripheral blood of 7 AA patients before and after treatment. Results: (1) The expression of CD4 + CD25 + Foxp3 + Treg in peripheral blood of AA patients was significantly lower than that of healthy controls (P <0.01); (2) The expression of CD4 + CD25 + Foxp3 + ); (3) The expression of CD4 + CD25 + Foxp3 + Treg in peripheral blood of AA patients after MSC treatment increased (P <0.05). (2) The expression of CD4 + CD25 + Foxp3 + Treg is lower in patients with SAA, suggesting that the expression of CD4 + CD25 + Foxp3 + Treg may be involved in the pathogenesis of AA. May be used as an indicator to judge the severity of AA; (3) MSC treatment can up-regulate the expression of CD4 + CD25 + Foxp3 + Treg in AA patients and provide a clinical basis for MSC to correct immune abnormalities in AA patients.