The Veriation Of Immunocyte Function In The Aplastic Anemia Patients With High Aluminum Exposure

Objective:To explore the change of immunological and the clinical characteristics in the aplastic anemia(AA)patients with high aluminum exposure.To analyze the relationship between the aluminum level and those immunological indexes.Methods:62 AA patients were selected in this study(33 cases with high aluminum exposure and 29 cases with non-aluminum exposure).We also studied 60 healthy people in two groups as controls.One healthy group of people with high aluminum exposure and the other healthy group of people with non aluminum exposure.The trace aluminum in human albumin solution was detected by inductivity coupled plasma mass spectrometry(ICP-MS);The level of cytokines(IL-10?IL-12?IL-17 and INF-?)were examined by enzyme-linked immunosorbent assay(ELISA);The distribution of lymphocyte subsets were examined by flow cytometric(FCM).At the same time,we collected the clinical date and the the expression level of immunoglobulin,complement C3?C4.Then the results were compared between the high aluminum exposure AA and non-aluminum exposure AA groups.We did the same procedure for healthy people who were exposed and not exposed to aluminum.Results:1.The level of serum aluminum of high aluminum exposure group(both AA patients and healthy people)was significantly higher(P< 0.05),besides,the level of serum aluminum of high aluminum exposure AA group was higher than that of none-aluminum exposure AA group and high aluminum exposure healthy people(both P< 0.01).2.The level of hemoglobin and bone marrow hematopoietic tissues were lower in AA patients from high aluminum exposured regions(both P<0.05),while there was no significant difference on age,sex,the number of white blood cells and neutrophils,the number of reticulocyte and platelet?degree of the bone marrow hyperplasia between both groups.3.The percentage of CD4 + T cells in peripheral blood from patients from high aluminum exposured places were significantly higher than that in non-aluminum exposured AA group and the healthy group(both P<0.05).The ration of CD4 +/ CD8+T cells from patients with high aluminum exposure were also higher than that in non-aluminum exposure AA group and healthy group(both P<0.05),while the percentage of CD8 + T cells was significantly lower than that in non aluminum exposured AA group(P< 0.05).The percentage of CD19+ and NK cells were the same in both groups.Correlation haven't been found between the level of serum aluminum and the percentage of CD4 + ?CD8 + T cells and the ration of CD4 +/ CD8+T cells(r=0.169,p=0.067;r=0.072,p=0.438;r=-0.039,p=0.679).4.Compared with non-aluminum exposured AA patients,the level of IFN-? and IL-10 in high aluminum exposure AA group are significantly higher(both P<0.05).However,the level of IL-17 ?IL-12 in non-aluminum exposure AA group and high aluminum exposure AA gruop was equal(both P>0.05).Correlation haven't been found between the level of serum aluminum and the level of IL-10(r=0.072,P=0.429)and IFN-?(r=0.480,P= 0.598).5.We haven't found any differencecs on the level of IgG?Ig A?IgE?IgM between high aluminum exposured AA group and non-aluminum exposured AA group.6.The level of complement C4 in high aluminum exposure AA group was lower than that in non-aluminum exposure AA group and healthy people(P<0.01,P<0.05),while there was no significant difference on the complement C3 level between these 2 groups(P>0.05).Correlation hasn't been found between the level of serum aluminum and the level of complement C4.Conclusion:High aluminum exposure might impair the immune function.The immunological and clinical characteristics in AA patients from high aluminum exposured regions are different from non-aluminum exposured AA patients,suggesting that the immune pathogenesis of AA may be different in both groups.