Aplastic Anemia Syndrome Differentiation Typing Related To The Pathogenesis Of Experimental Research

Aplastic anemia (AA), which is pancytopenia with bone marrow failure caused by physical, chemical and biological reasons. Clinically it can be divided into two kinds, that is acute aplastic anemia and chronic aplastic anemia. The former has an acute cause and often a higher mortality, while the latter has a relatively chronic cause and a better prognosis. Traditional Chinese medicine (TCM) is effective in treatment of AA.In theory, bone marrow failure in aplastic anemia could be the consequence of damage either to hematopoietic cells or to stromal cells required for their production. In addition, hematopoietic failure in aplastic anemia is also mediated by cytotoxic T lymphocytes that are detectable in peripheral blood. In this paper, we will discuss relationships between pathogenesis of AA and different syndromes according to TCM theory.Objective: To study relationships between pathogenesis of AA and different syndromes according to TCM theory. Also to discuss the feasibility of establishing objective laboratory indexes for different syndromes of AA according to TCM theory.Methods: According to TCM theory, AA was divided into three syndromes, which is essence and Yang deficiency syndrome, essence deficiency and toxin accumulating syndrome , essence deficiency and blood stasis syndrome. Colony forming unit-granulocyte macrophage (CFU-GM) and peripheral blood CD34 were used to estimate abnormality of hematopoietic stem cells/progenitor cells; CD4, CD8 and CD4/CD8 were used to evaluate function of T lymphocyte; Histology of bone marrow was used to observe hematopoietic micro-environment. To analysis relationships between the above indexes and different syndromes of AA according to TCM theory in the end .Results: In the essence and Yang deficiency syndrome, decreasing of CFU-GM was dominant. In the essence deficiency and toxin accumulating syndrome, we also found decreasing of CD4 and increasing of CD8 with an inversed CD4/CD8; in addition, bone marrow histology of this syndrome showed obvious necrosis and bleeding. In the essence deficiency and blood stasis syndrome, bleeding was more severe according to bone marrow histology, while T lymphocyte abnormal was not obvious.Conclusion: Essence deficiency and toxin accumulating syndrome of AA is less severer than other two syndromes, and pathogenesis of this syndrome is mostly relied on abnormality of hematopoietic stem cells/progenitor cells. Essence deficiency and toxin accumulating syndrome is the severest of AA, and pathogenesis of this syndrome is mostly relied on abnormality of T lymphocyte.