血液疾病骨髓細胞體外造血及其受顆粒狀單核球促造血因子〈GM-EA〉影響之研究

In Vitro Granulomonopoiesis of Bone Marrow Cells and Thier Response to Granulomonopoietic Enhancing Activity in Patients with Hematologic Disorders

鐘來如(Lan-Lu Chong) ； 王聲遠(Sheng-Yuan Wang) ； 陳怜燕(Ling-Yang Chen) ； 周永強(Wing-Deung Chau) ； 姜幼民(Yu-Ming Chiang) ； 何照洪(Chao-Hung Ho)

《The Kaohsiung Journal of Medical Sciences》 3卷4期 (1987/04) Pp. 251-257

https://doi.org/10.6452/KJMS.198704.0251

摘要

正常人類骨髓造血必須各種調節因子以適量控制其造血，此因子包括顆粒巨噬球集落刺激因子〈GM-CSF〉，這種現象可在體外予以證實。此外，一種新近發現顆粒球單核球促造血因子〈GM-EA〉可使骨髓有核細胞體外造血增加約75%。本研究即探討在病態情況下，患者骨髓細胞體外造血〈加CSF〉及其受顆粒球單核球促造血因子〈除CSF外另加，或不加〈GM-EA〉影響之情型。並以體外造血〈CFU-GM〉即colony 加 cluster之和〉增加20%以上者為陽性GM-EA 反應。
結果發現嚴重型再生不良性貧血骨髓細胞體外造血〈僅有加CSF〉最差。中度再生不良性貧血及骨髓發育不良症者次之，骨髓纖維化症及脾功能亢進症導致末梢血球數異常者，其骨髓體外造血與正常對照者相差無幾。末梢血原發性中性球減少症方面，其骨髓體外造血非常旺盛。末梢血白血球數增多症〈次發性〉則骨髓體外造血明顯增高。附加GM-EA後，再生不良性貧血嚴重型未見陽性反應。中型者則約有60%呈陽性反應。中性球減少症者，及骨髓纖維化症者之GM-EA反應不明顯。脾功能亢進症引起末梢白血球減少症者，其替外造血對GM-EA有顯著陽性反應。不同病症骨髓有核細胞在體外造血呈現不同造血程度，對GM-EA反應亦有差異。可能之原因本文略有討論。

並列摘要

Many investigations have shown that the granulocyte-macrophage colony stimulating factor (GM-CSF) plays an important role in the regulation of granulomonopoiesis. Recently, another new hematopoietic growth factor has been identified, namely, the granulomonopoietic enhancing activity (GM-EA). This activity can promote the colony formation induced by GM-CSF to a fairly high extent (60-80% enhancement) in normal marrow samples. In this report, we studied the in ritro granulomonopoiesis of patients with various blood disorders and examined the effects of GM-EA on the granulocyte-macrophage colony formation of their marrow cells. The reaction of GM-EA was considered positive reaction of GM-EA was considered positive when the percentage of enhancement of CFU-GM colony formation was over20.
Result of our study has shown a very poor granulomonopoiesis in patients with severe aplastic anemia, and a poor granulomonopoiesis in those with moderate severe aplastic anemia and myelodysplastic syndrome. Conversely, the number of bone marrow CFU-GM was normal in patients with myelofibrosis or hypersplenism and markedly increased in patients with primary neutropenia or secondary leukocytosis. The effects of GM-EA on CFU-GM colony formation were different in patients with different blood diseases. An apparent positive effect of GM-EA was noted in neutropenia caused by hypersplenism. About 60% of patient with moderate severe aplastic anemia revealed a positive GM-EA reaction in their marrow cultures, but no positive effect was seen when GM-EA was added to CFU-GM assay of marrow cells from patient with severe aplastic anemia and myelodysplastic syndrome. The granulomonopoiesis and the effects of GM-EA on CFU-GM formation in patients with different blood are briefly discussed.

並列關鍵字

hematologic disorders ； granulocyte-macrophage colony stimulating factor(GM-CSF) ； granulomonopoietic enhancing activity(GM-EA)