Bone Marrow Angiogenesis in Patients Presenting with Differential Chinese Medicine Syndrome:Correlation with the Clinico-pathological Features of Aplastic Anemia

Objective:To explore differences in bone marrow angiogenesis seen in aplastic anemia(AA)patients presenting with differential Chinese medicine(CM)syndrome,and to correlate these differences with clinical pathology.Methods:Thirty-five patients were enrolled,including 18 with"yang deficiency syndrome"and 17 with"yin deficiency syndrome."Bone marrow biopsies and serum were collected.Microvessel density(MVD)and positive expression of vascular endothelial-derived growth factor(VEGF)were detected by immunohistochemisty.Hypoxia inducible factor-1α(HIF-1α),and VEGF expression were assayed by enzyme-linked immunoabsorbent assay(ELISA),serum lactate dehydrogenase(LDH)was tasted by enzyme method and liquid chip technology was used to detected the expression of interleukin(IL)-2,IL-4,IL-6,IL-10,interferon(IFN)-γand tumor necrosis factor(TNF)-α.Results:Counts for leukocytas,absolute neutrophils and platelets in"yin deficiency syndrome"were lower than those found in"yang deficiency syndrome"(P<0.05).MVD and VEGF expression,and the positive rate of CD34 and VEGF in bone marrow were lower in AA,especially in"yin deficiency syndrome"(P<0.01 or P<0.05)."Yin deficiency syndrome"displayed decreased VEGF and LDH expression,and enhanced expression of HIF-1αas compared to"yang deficiency syndrome"(P<0.05).Levels of IL-4 and IL-6 were higher in AA(P<0.01),but IL-10 was decreased(P<0.05).High TNF-αexpression was seen in"yang deficiency syndrome"and IFN-γexpression was decreased in"yin deficiency syndrome"as compared with normals(P<0.01 and P<0.05,respectively).Conclusion:AA patients have lower MVD than normals,especially in"yin deficiency syndrome."MVD might differentially correlate to disease severity,and could be dependent on bone marrow or serum VEGF expression and LDH.Additionally,IL-2,IL-10,IL-4and IFN-γwere negatively associated while IL-6 and TNF-αwere positively associated with MVD.