ПАТОГЕНЕЗ АПЛАСТИЧЕСКОЙ АНЕМИИ (ОБЗОР ЛИТЕРАТУРЫ)
Аннотация
Апластическая анемия является редкой и опасной для жизни недостаточностью костного мозга, которая приводит к цитопении периферической крови и снижению пролиферации гемопоэтических клеток костного мозга. Симптомы сходны с миелофиброзом, миелодиспластическими синдромами и острым миелоидным лейкозом, что затрудняет диагностику данного заболевания. Патогенез апластической анемии сложен, и его механизм необходимо расшифровывать на индивидуальной основе. В этом обзоре обобщаются несколько вкладов, сделанных в последние годы в попытке понять патогенез апластической анемии, которые могут быть полезны для разработки персонализированных методов лечения данного заболевания.
Ключевые слова:
апластическая анемия, определение, патогенез, гемопоэтические стволовые клетки, клетки-предшественники, иммунная дисфункция.Библиографические ссылки
1. Bär C, Povedano JM, Serrano R, Benitez-Buelga C, Popkes M, Formentini I et al. gene therapy rescues telomere length, bone marrow aplasia, and survival in mice with aplastic anemia. Blood. 2016;127(14):1770–1779. https://doi.org/10.1182/blood-2015-08-667485
2. Fan R, Wang W, Wang XQ, Lin GW. Incidence of adult acquired severe aplastic anemia was not increased in Shanghai, China. Ann Hematol. 2011;90(10):1239–1240. https://doi.org/10.1007/s00277-011-1168-5
3. Li SS, Hsu YT, Chang C, Lee SC, Yen CC, Cheng CN et al. Incidence and treatment outcome of aplastic anemia in Taiwan-real-world data from single-institute experience and a nationwide population-based database. Ann Hematol. 2019;98(1):29–39. https://doi.org/10.1007/s00277-018-3486-3
4. Садабаев Э.М., Мамажакып уулу Ч., Эралиева М.О., Джакпыбаев О.А., Маматов С.М. Эффективность иммуносупрессивной терапии при тяжелой форме апластической анемии. Вестник КРСУ. 2020; 20(5).70-74. [Sadabaev E.M., Mamazhakyp u. Chyngyzbek, Eralieva M.O., Dzhakypbaev O.A., Mamatov S.M. The effectiveness of immunosuppressive therapy in severe form of aplastic anemia. Vestnik KRSU.2020;20(5):70-74 (In Russ.)]
5. Akram Z, Ahmed P, Kajigaya S, Satti TM, Satti HS, Chaudhary QUN et al. Epidemiological, clinical and genetic characterization of aplastic anemia patients in Pakistan. Ann Hematol. 2019;98(1):301–312. https://doi.org/ 10.1007/S00277-018-3542-Z
6. Maciejewski JP, Selleri C, Sato T, Anderson S, Young NS. A severe and consistent deficit in marrow and circulating primitive hematopoietic cells (long-term culture-initiating cells) in acquired aplastic anemia. Blood. 1996;88(6):1983–1991.
7. Timeus F, Crescenzio N, Doria A, Foglia L, Linari A, Giacconeet M al. Flow cytometric evaluation of circulating CD34+ cell counts and apoptotic rate in children with acquired aplastic anemia and myelodysplasia. Exp Hematol. 2005;33(5):597–604. https://doi.org/10.1016/j.exphem.2005.02.005
8. Wu L, Mo W, Zhang Y, Deng H, Li Y, Zhouet R al. Impairment of hematopoietic stem cell niches in patients with aplastic anemia. Int J. Hematol. 2015;102(6):645–653. https://doi.org/10.1007/s12185-015-1881-2
9. Gao GF, Jakobsen BK. Molecular interactions of coreceptor CD8 and MHC class I: the molecular basis for functional coordination with the T-cell receptor. Immunol Today. 2000;21(12):630–636. https://doi.org/10.1016/s0167-5699(00)01750-3
10. Nakagawa MM, Rathinam CV. Constitutive activation of the canonical NF-kappaB pathway leads to bone marrow failure and induction of erythroid signature in hematopoietic stem cells. Cell Rep. 2018;25(8):P2094–2109.E4. https://doi.org/10.1016/j.celrep.2018.10.071
11. Young NS, Calado RT, Scheinberg P. Current concepts in the pathophysiology and treatment of aplastic anemia. Blood. 2006;108(8):2509–2519. https://doi.org/10.1182/blood-2006-03-010777
12. Young NS. Hematopoietic cell destruction by immune mechanismsn acquired aplastic anemia. Semin Hematol. 2000;37(8):3–14. https://doi.org/10.1182/blood-2006-03-010777
13. Locasciulli A, Oneto R, Bacigalupo A, Socié G, Korthof E, Bekassy A et al. Outcome of patients with acquired aplastic anemia given first line bone marrow transplantation or immunosuppressive treatment in the last decade: a report from the European group for blood and marrow transplantation (EBMT). Haematologica. 2007;92(1):11–18. https://doi.org/10.3324/ haematol.10075
14. Chuncharunee S, Wong R, Rojnuckarin P, Chang CS, Chang KM, Lu MY et al. Efficacy of rabbit antithymocyte globulin as first-line treatment of severe aplastic anemia: an Asian multicenter retrospective study. Int J Hematol. 2016;104(4):454–461. https://doi.org/10.1007/s12185-016-2053-8
15. Chen J, Desierto MJ, Feng X, Biancotto A, Young NS. Immune-mediated bone marrow failure in C57BL/6 mice. Exp Hematol. 2015;43(4):256–267. https://doi.org/10.1016/j.exphem.2014.12.006
16. Wilson A, Laurenti E, Oser G, Van der Wath RC, Blanco-Bose W, Jaworski M et al. Hematopoietic stem cells reversibly switch from dormancy to self-renewal during homeostasis and repair. Cell. 2008;135(6):1118–1129. https://doi.org/10.1016/j.cell.2008.10.048
17. Sertorio M, Du W, Amarachintha S, Wilson A, Pang Q. In vivo RNAi screen unveils PPARgamma as a regulator of hematopoietic stem cell homeostasis. Stem Cell Rep. 2017;8(5):1242–1255. https://doi.org/10.1016/j.stemcr.2017.03.008
18. de Bruin AM, Demirel O, Hooibrink B, Brandts CH, Nolte MA. Interferongamma impairs proliferation of hematopoietic stem cells in mice. Blood. 2013;121(18):3578–3585. https://doi.org/10.1182/blood-2012-05-432906
19. Gonzaga VF, Wenceslau CV, Lisboa GS, Frare EO, Kerkis I. Mesenchymal stem cell benefits observed in bone marrow failure and acquired aplastic anemia. Stem Cells Int. 2017;2017:8076529. https://doi.org/10.1155/2017/8076529
20. Maruyama H, Katagiri T, Kashiwase K, Shiina T, Sato-Otsubo A, Zaimoku Y et al. Clinical significance and origin of leukocytes that lack HLA-A allele expression in patients with acquired aplastic anemia. Exp Hematol. 2016;44(10):P931–939. https://doi.org/10.1016/j.exphem.2016.05.013
21. Gonzalez-Galarza FF, Takeshita LY, Santos EJ, Kempson F, Maia MHT, Soares da Silva AL et al. Allele frequency net 2015 update: new features for HLA epitopes, KIR and disease and HLA adverse drug reaction associations. Nucleic Acids Res. 2015; 43 (Database issue): D784–D788. https://doi.org/10.1093/nar/gku1166
22. Tichelli A, Schrezenmeier H, Socie G, Marsh J, Bacigalupo A, Dührsen U et al. A randomized controlled study in patients with newly diagnosed severe aplastic anemia receiving antithymocyte globulin (ATG), cyclosporine, with or without G-CSF: a study of the SAA working party of the European group for blood and marrow transplantation. Blood. 2011;117(17):4434–4441. https://doi.org/10.1182/blood-2010-08-304071
23. Yoshizato T, Dumitriu B, Hosokawa K, Makishima H, Yoshida K, Townsley D et al. Somatic mutations and clonal hematopoiesis in aplastic anemia. N Engl J Med. 2015;373(1):35–47. https://doi.org/10.1056/NEJMoa1414799
24. Liu C, Li Z, Sheng W, Fu R, Li L, Zhang T et al. Abnormalities of quantities and functions of natural killer cells in severe aplastic anemia. Immunol Invest. 2014;43(5):491–503. https://doi.org/10.3109/08820139.2014.888448
25. Sun W, Wu Z, Lin Z, Hollinger M, Chen J, Feng X et al. Macrophage TNF-alpha licenses donor T cells in murine bone marrow failure and can be implicated in human aplastic anemia. Blood. 2018; 132(26): 2730–2743. https://doi:10.1182/blood-2018-05-844928
26. Zaimoku Y, Takamatsu H, Hosomichi K, Ozawa T, Nakagawa N, Imi T et al. Identification of an HLA class I allele closely involved in the autoantigen presentation in acquired aplastic anemia. Blood. 2017;129(21):2908–2916. https://doi.org/10.1182/blood-2016-11-752378
27. Zeng Y, Katsanis E. The complex pathophysiology of acquired aplastic anaemia. Clin Exp Immunol. 2015;180(3):361–370. https://doi.org/10.1111/cei.12605
