Impaired Immune Privilege Exclusive to HSCs Mediated by Tregs is
associated with HSCs Exhaustion in children with Aplastic Anemia
Abstract
A series of immune abnormalities presenting in aplastic anemia (AA)
support the immune pathogenesis of AA. However, how abnormal immunity
specifically damages hematopoietic stem cells (HSCs) remains ambiguous.
The discovery of bone marrow immune privilege (IP) sites which are
composed of CD4 +CD25 +FoxP3
+ regulatory T cells (Tregs) exclusively to protect
HSCs prompted us boldly assumed that it is a loss of IP protection
leading to HSCs exhausted in AA. A experiment study to clinically
confirm the correlation between HSCs depletion and IP abnormalities in
patients with AA was conducted. The distribution of Tregs in bone marrow
from children with AA, myelodysplastic syndrome (MDS) and control group
was detected by immunohistochemistry. Th1, Th2, Th17 and HSCs as well as
cytokines in bone marrow of these children were examined by flow
cytometry. Tregs near endostea surface of bone marrow of children with
AA was significantly lower than that in control and MDS. Th1 was more
predominant in AA than in the control children. TNF-α, IFN-γ and IL-17
levels were also increased in AA. Compared to the control group, HSCs in
bone marrow of AA, including Long-term HSCs (LT-HSCs) and Short-term
HSCs (ST-HSCs), were at lower level. The results indicate that HSCs
depletion is closely related to bone marrow IP abnormalities in AA, and
the role of IP abnormalities in the pathogenesis of aplastic anemia
deserves further research.