Aplastic anaemia (AA) is a heterogenous disease including different pathophysiological conditions, characterized by severely diminished numbers of bone marrow (B.M) haematopiotic cells resulting in failure of the marrow to produce mature blood elements, this study aimed to determine the role of apoptosis, tumour necrosis factor alpha (TNFa) and granulocytes-macrophage colony stimulating factor (GMCSF) in the pathogensis of AA. Thirty five cases diagnosed as acquired A.A,Twenty cases newly diagnosed , 8 cases in partial remission and 7 cases in complete remission were studied. Twenty age and sex matched children were taken as control group. Mononuclear cell apoptosis was estimated using flowcytometry by TUNEL method.Serum level of TNFa and GM-CSF were estimated using ELISA technique. The result of this study revealed significant increase of mononuclear cell apoptosis and TNFa in newly diagnosed cases of AA and in cases with partial remission more than in control group. Also there was an insignificant increase of apoptosis in the cases in complete remission than in control group. Serum GM-CSF was significantly reduced in all cases of aplastic anaemia except cases in complete remission when compared with control group.There was inverse correlation between mononuclear cell apoptosis,TNFa, and GM-CSF (r —0.52 , - 0.55 respectively , p <0.001) In conclusion increase the rate of mononuclear cell apoptosis,TNF-a and decreased level of GM-CSF play a role in pathophysiology of B.M failure and their follow up may be one of the important parameters to assure complete recovery. |
