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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。
Objective To detect the total amount of peripheral blood dendritic cells (DCs), the proportion of subpopulations (pDC and mDC) and the expression of co-stimulatory molecules (cD80, CD86 and CD40) in patients with myelodysplastic syndrome (MDS) Abnormal formation mechanism. Methods Thirty-eight MDS patients and 19 normal controls were selected. Lin1 ~ -HLA-DR ~ + cells (DCs), Lin1 ~ -HLA-DR CD123 + cells (pDC), Linl ~ -HLA-DR ~ + CD11c ~ + cells (mDC) and the expression of CD80, CD86 and CD40 on DCs. Results The total amount of peripheral blood DC in low-risk MDS group, high-risk MDS group and normal control group were (33.7 ± 7.0) × 10-6 / L, (56.3 ± 29.0) × 10-6 / L and (12.1 ± 1.4) × The numbers of pDC were (12.6 ± 4.1) × 10 ~ 6 / L, (3.6 ± 1.0) × 10 ~ 6 / L and (6.6 ± 0.7) × 10 ~ 6 / L (16.7 ± 6.3) × 10 ~ 6 / L, (28.7 ± 17.6) × 10 ~ 6 / L and (5.5 ± 0.9) × 10 ~ 6 / L, . The percentage of peripheral blood mononuclear cells (PBMNC) in low risk MDS group, high risk MDS group and normal control group were (2.37 ± 0.53)%, (3.58 ± 1.39)% and (0.68 ± 0.08)%, respectively (0.82 ± 0.29)%, (0.31 ± 0.06)% and (0.37 ± 0.04)%, respectively (P> 0.05). The percentages of mDC in PBMNC were (0.96 ± 0.35)% and (1.51 ± 0.70) )% And (0.32 ± 0.05)% (P <0.05). The CD80 ~ + DC in peripheral blood of low-risk MDS group, high-risk MDS group and normal control group were (30.6 ± 11.8) × 10-6 / L, (2.3 ± 0.9) × 10-6 / L and (2.3 ± 0.6) (25.1 ± 7.4) × 10.6 / L, (12.4 ± 6.3) × 10 ~ 6 / L, and (6.2 ± 3.2) × 10 ~ 6 / (P <0.05), CD40 ~ + DC were (2.8 ± 1.0) × 10 ~ 6 / L, (1.5 ± 0.9) × 10 ~ 6 / L and (3.2 ± 2.3) × 10 ~ 6 / L > 0.05). Conclusions The number of DC in peripheral blood of patients with MDS is increased and the proportion is abnormal. The increase of mDC mainly results in no increase of pDC. The expression of CD80 and CD86 in CDS of MDS patients is high but the expression of CD40 is not increased. It suggested that the number of antigen-presenting cells (pDC) induced by anti-tumor cells in MDS patients was insufficient and the number of antigen presenting cells (mDC) related to the inflammatory injury of normal hematopoietic clots increased. This may be one of the important mechanisms leading to cellular immune dysfunction in MDS patients.