The Change And Signifisance Of Androgen And Androgen Receptor In Aplastic Anemia

Objective: To explore the function of androgen-androgen receptor way in immune pathogenesis in chronic aplastic anemia by measuring the level of androgen in peripheral blood, androgen receptor in nuclear and /or plasma in bone marrow mononuclear cells and T lymphocyte subpopulations in bone marrow ,and to analyze the correlation of androgen receptor expression and state when newly diagnosed as well as prognosis treated with androgen in bone marrow in chronic aplastic anemia patients. Methods:⑴Radioimmunoassay was used to investigate the contents of testosterone in plasma of 20 chronic aplastic anemia patients.⑵Immunocytochemistry was performed to evaluate the positive level of androgen receptor in nuclear and plasma of bone marrow mononuclear cells in 20 newly diagnosed patients,18 patients with treatment of androgen for three months and 25 healthy controls.⑶Flow cytometry was used to evaluate the contents of T- lymphocyte subpopulations(CD3+CD4+ cells,CD3+CD8+ cells) and activated Ts lymphocytes(CD8+CD25+ cells,CD8+HLA-DR+ cells) in bone marrow in newly diagnosed patients,patients treated with androgen and healthy people. Results: The level of testosterone in male is significantly higher than that of female in each of the above three groups, while there was no significant difference among the three groups mutually. The positive contents of andogen receptor in bone marrow in newly diagnosed group are significantly lower than those of the treatment group and the control group, and those of treatment group are also lower than control group. The level of testosterone and the positive contents of androgen receptor were in linear correlation, and the contents of CD3+CD8+ lymphocytes and CD8+HLA-DR+ lymphocytes in newly diagnosed group were significantly higher than those of the treatment group and the control group, and the contents of CD3+CD8+ lymphocytes in the treatment group were significantly higher than those of the control group, while there were no significant difference in CD3+CD4+ cells and CD8+CD25+ cells among the above three groups. In addition, the positive contents of androgen receptor in bone marrow had relationship with reticulocyte count in peripheral blood,CD3+CD8+ lymphocytes in bone marrow before treatment, and with reticulocyte count,bone marrow hyperplasia response,CD3+CD8+ lymphocytes in bone marrow after treatment of androgen for three months. Conclusion: The expression of androgen receptor in nuclear and plasma of bone marrow mononuclear cells when newly diagnosed was less than that of healthy people, therefore the function of androgen to stimulate hematopoiesis in bone marrow was reduced. The abnormally increased CD3+CD8+ lymphocytes and CD8+HLA-DR+ lymphocytes in bone marrow of the CAA patients when newly diagnosed were significantly reduced after treatment with androgen , and the amount of AR expression in bone marrow of those patients had relationship with the contents of CD3+CD8+ lymphocytes in bone marrow before and after administration of androgen, which suggested the abnormality of androgen-androgen receptor way may function in the abnormality of cellular immune in pathogenesis of chronic aplastic anemia. The expression of androgen receptor in bone marrow when newly diagnosed had relationship with several parameters such as CD3+CD8+ lymphocytes and reticular cells before and after treatment of androgen, which suggest identifying the expression of androgen receptor when newly diagnosed may be valuable in indicating state and expecting prognosis in chronic aplastic anemia.