CAJ | 학술논문

目的：通过检测再生障碍性贫血（AA）患儿T细胞内mTOR信号途径分子及T细胞内调控因子GAS5的表达水平，初步探讨该信号途径在儿童AA中的改变。方法（1）对16例初治重型AA（SAA）及8例免疫抑制剂治疗（IST）有效的SAA患儿，用流式细胞术（FCM）方法检测外周血CD3＋T细胞内mTOR信号途径分子磷酸化Akt（p-Akt）、磷酸化TSC2（p-TSC2）、磷酸化mTOR （p-mTOR）、磷酸化4EBP1（p-4EBP1）及磷酸化p70S6K（p-p70S6K）的表达水平。（2）用实时荧光定量聚合酶连反应（QRT-PCR）方法检测23例初治SAA及7例IST有效SAA患儿骨髓CD3＋T细胞内调控因子 GAS5的表达水平。结果（1）初治 SAA 组外周血 CD3＋T 淋巴细胞内 p-Akt、p-TSC2、p-mTOR、p-4EBP1及p-p70S6K表达水平均明显高于正常对照组，而低于阳性对照CEM细胞株组；（2）SAA 治疗有效组外周血 CD3＋T 淋巴细胞内 p-Akt、p-TSC2、p-mTOR、p-4EBP1及p-p70S6K的表达水平均均低于初治SAA组；SAA治疗有效组p-Akt、p-TSC2、p-mTORC1、p70S6K的表达水平与正常对照组无明显差异，但p-4EBP1的表达水平高于正常对照组。（3）初治SAA组骨髓CD3＋T淋巴细胞内GAS5的表达量明显低于正常对照组，而显著高于CEM细胞株组。（4）SAA治疗有效组骨髓CD3＋T淋巴细胞内GAS5的表达水平高于初治SAA组，而与正常对照组无明显差异。结论（1）mTOR信号途径的活化程度与疾病状态相关，初治SAA患儿外周血细胞中p-Akt、p-TSC2、p-mTOR、p-4EBP1、p-p70S6K表达升高，说明mTOR信号在SAA患儿中呈活化状态，可能参与AA的T细胞的免疫异常。（2）初治SAA患儿骨髓T细胞内GAS5表达水平明显低于正常儿童而显著高于 CEM细胞，SAA 治疗有效后 GAS5表达水平明显升高，GAS5的表达水平可能与mTOR信号途径的活化存在一定负相关。GAS5可能为负性调控因子。
목적：통과검측재생장애성빈혈（AA）환인T세포내mTOR신호도경분자급T세포내조공인자GAS5적표체수평，초보탐토해신호도경재인동AA중적개변。방법（1）대16례초치중형AA（SAA）급8례면역억제제치료（IST）유효적SAA환인，용류식세포술（FCM）방법검측외주혈CD3＋T세포내mTOR신호도경분자린산화Akt（p-Akt）、린산화TSC2（p-TSC2）、린산화mTOR （p-mTOR）、린산화4EBP1（p-4EBP1）급린산화p70S6K（p-p70S6K）적표체수평。（2）용실시형광정량취합매련반응（QRT-PCR）방법검측23례초치SAA급7례IST유효SAA환인골수CD3＋T세포내조공인자 GAS5적표체수평。결과（1）초치 SAA 조외주혈 CD3＋T 림파세포내 p-Akt、p-TSC2、p-mTOR、p-4EBP1급p-p70S6K표체수평균명현고우정상대조조，이저우양성대조CEM세포주조；（2）SAA 치료유효조외주혈 CD3＋T 림파세포내 p-Akt、p-TSC2、p-mTOR、p-4EBP1급p-p70S6K적표체수평균균저우초치SAA조；SAA치료유효조p-Akt、p-TSC2、p-mTORC1、p70S6K적표체수평여정상대조조무명현차이，단p-4EBP1적표체수평고우정상대조조。（3）초치SAA조골수CD3＋T림파세포내GAS5적표체량명현저우정상대조조，이현저고우CEM세포주조。（4）SAA치료유효조골수CD3＋T림파세포내GAS5적표체수평고우초치SAA조，이여정상대조조무명현차이。결론（1）mTOR신호도경적활화정도여질병상태상관，초치SAA환인외주혈세포중p-Akt、p-TSC2、p-mTOR、p-4EBP1、p-p70S6K표체승고，설명mTOR신호재SAA환인중정활화상태，가능삼여AA적T세포적면역이상。（2）초치SAA환인골수T세포내GAS5표체수평명현저우정상인동이현저고우 CEM세포，SAA 치료유효후 GAS5표체수평명현승고，GAS5적표체수평가능여mTOR신호도경적활화존재일정부상관。GAS5가능위부성조공인자。
Objective ToinvestigatethechangesofmTORsignalingpathwayinchildhoodsevere aplastic anemia by detecting the expression levels of the molecules of mTOR signaling pathway and GAS5 in T cells.Methods (1 )The expressions of p-Akt,p-TSC2,p-mTOR,p-4EBP1 ,p-p70S6K in CD3 +T cells in peripheral blood were detected by flow cytometry (FCM).Peripheral blood samples were collected from 1 6 newly diagnosed severe aplastic anemia(SAA)patients and 8 patients with effective immunosuppressive therapy (IST).(2 )The expression of GAS5 in CD3 +T cells in bone marrow mononuclear cells were detected by real time quantitative polymerase chain reaction (RT-PCR).And bone marrow samples were collected from 23 newly diagnosed SAA patients and 7 patients with effective IST.Results (1 )The expressions of p-Akt,p-TSC2,p-mTOR,p-4EBP1 ,p-p70S6K of the newly diagnosed SAA group were significantly higher than the normal control group.(2 )The expressions of p-Akt,p-TSC2,p-mTOR,p-4EBP1 and p-p70S6K of the effective treatment groups were much lower than the newly diagnosed SAA group;the expressions of p-Akt,p-TSC2,p-mTOR,p-p70S6K were similar to the normal control group (P>0.05 ),but the expression of p-4EBP1 was higher.(3 )The expression of GAS5 of the newly diagnosed SAA group were lower than the normal control group.(4) The expression of GAS5 of the effective treatment group was higher than the newly diagnosed SAA group, but was similar to the normal control group.Conclusions (1 )The expressions of p-Akt,p-TSC2, p-mTOR,p-4EBP1 ,p-p70S6K were increased in the newly diagnosed SAA patients,and were much higher than the effective treatment groups,which suggested that the mTOR signaling pathway was activated in SAA patients.And the degree of activation of mTOR signaling pathway was positively associated with the disease states.The signaling pathways may be involved in the T cell-mediated immune abnormalities in the pathogenesis of AA.(2 )The expression of GAS5 in the newly diagnosed SAA patients was decreased but increased in the effective treatment of children with SAA.The expression level of GAS5 may be negatively correlated with the activation of mTOR signaling pathway.