| Objectives:To investigate the expression of na ve,central memory and effector memory T cellsubsets in peripheral blood of severe aplastic anemia (SAA) patients before and aftertreated with immunosuppressive therapy (IST), and to explore IST treatment of naive andmemory T cell subsets and therapeutic response correlation.Methods:The newly diagnosed group of16patients with SAA, with a median duration of2.8months, were not receiving immunosuppressive therapy before, including8males and8females, median age:33years, range23to67years.The treated group of9SAA patients which were treated with IST,with a medianduration of2.5months,6males and3females, median age:28years, range12to60years.The normal control group:10cases of healthy adults,6males and4females,median age:28.5years, range19to45years.Mononuclear cells were separated and extracted by lymphocyte separation mediumfrom4ml peripheral blood in the morning of each subject for flow cytometry detection.Based on CD4+and CD8+T cell surface expressing CD45RA,CD45RO andCD62L were divided into na ve T cells (CD45RA+CD62L+，TN), central memory Tcells (CD45RO+CD62L+,TCM), effector memory T cells (CD45RO+CD62L-,TEM).By polychromatic flow cytometry detecting16SAA newly diagnosed group,9thetreated group and10normal control group CD4+and CD8+TN, TCM and TEM cellssubsets in the peripheral blood.Results:1. Flow cytometry detection showed that the percentage of CD4+T cells in newlydiagnosed group was (12.57±5.86)%, the treated group was (14.24±5.20)%, thepercentage of CD4+T cells in the newly diagnosed group and treatment group wassignificantly lower than the control group(24.97±8.91)%(P <0.01).The percentage ofCD4+T cells in the newly diagnosed group and treatment group was significantly lowerthan the control group[(24.97±8.91)%](P <0.01).The percentage of CD8+T cells in newly diagnosed group was (23.83±7.10)%, thetreated group was (19.46±9.55)%, the normal control group was (16.28±6.43)%, thenewly diagnosed group was significantly higher than the normal control group(P<0.05).There was no statistical difference between the newly diagnosed group andtreated group, and the same as between the treatment group and the control group (P>0.05).The ratio of CD4+/CD8+was (0.53±0.22) in the newly diagnosed group, thetreated group was (0.85±0.49),the ratio of CD4+/CD8+in the newly diagnosed groupand treated group was significantly lower than the normal control group (1.56±0.25)(P<0.01), the ratio of CD4+/CD8+in the newly diagnosed group was significantly lowerthan the treatment group (P <0.05).The percentage of CD4+TN, CD4+TCM, CD4+TEM cells in CD4+cells in thenewly diagnosed group were (4.93±3.91)%,(5.96±3.24)%,(3.49±2.76)%, thepercentage of the treatment group were (5.24±3.71)%,(5.77±3.10)%,(4.85±2.31)%,the normal control group were (9.64±3.54)%,(10.14±3.45)%,(7.40±2.90)%. Thepercentage of CD4+TN, TCM and TEM cells in the newly diagnosed group and treated group were significantly lower than the normal control group(P<0.05), there were nostatistical difference between the newly diagnosed group and treated group (P>0.05).The percentage of CD8+TN, CD8+TCM, CD8+TEM cells in CD8+cells in thenewly diagnosed group were (5.65±4.51)%,(8.28±3.01)%,(6.82±3.37)%,thepercentage of the treatment group were (4.83±4.25)%,(7.53±2.67)%,(4.21±2.49)%,the normal control group were (6.96±3.44)%,(5.84±4.07)%,(3.59±2.53)%.Thepercentage of CD8+TN, TCM in the newly diagnosed group and treated group were nostatistical difference than the normal control group(P>0.05). The percentage of CD8+TEM cells in the newly diagnosed group was significantly higher than the treated groupand the normal control group(P<0.05).2. The percentage of CD4+TN, CD8+TN,CD8+TEM cells were negativelycorrelated with age (r=-0.335, P <0.05; r=-0.469, P <0.05; r=-0.415, P<0.05). CD4+,CD8+, CD4+TCM, CD4+TEM, CD8+TCM cells were not correlated with age (r=-0.250, P>0.05; r=－0.198, P <0.05; r=-0.215, P>0.05; r=-0.120, P>0.05; r=-0.320,P>0.05).3. The routine blood levels of the SAA newly diagnosed group were: WBC1.26×109/L, NUE0.19×09/L, Hb61g/L, Ret3.43×109/L, PLT15.5×109/L. Morethan3months of treatment group convalescent blood levels: WBC3.15×109/L, NUE1.22×109/L, Hb108g/L, Ret45.53×109/L, PLT31×109/L. WBC, NUE, Hb, Ret,PLT in the two groups were significantly difference, P <0.05.Conclusion:SAA patients are with cellular dysimmunity, increasing CD8+TEM cells, whichmight contribute to the bone marrow failure. IST can reduce the proportion of CD8+TEM cells, which might be one of the remission mechanisms of SAA. |
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