目的：探讨骨髓增生异常综合征（myelodysplastic syndrome，MDS)患者骨髓来源间充质干细胞( mesenchymal stemcell, MSC)成骨分化特点及其临床意义。方法: 骨髓标本取自河北大学附属医院血液内科30 例未经治疗的新诊断的MDS患者。分离培养MDS患者及正常人的MSC，体外培养并观察MSC的形态学特点。在适当条件下诱导MSC向成骨细胞和成脂细胞分化，茜素红染色观察成骨诱导分化第14 天钙结节形成情况，实时荧光定量PCR法检测未分化MSC中成骨分化转录因子Ostefix、RUNX2 以及参与造血细胞向白血病细胞转化的Jagged-1 的mRNA表达水平。结果：MDS患者的骨髓来源的MSC表现为细胞体积增大、分化潜能下降。与对照组相比，成骨分化转录因子Osterix 和RUNX2 表达水平明显下降(均P<0.05)；茜素红染色结果显示，MDS组钙结节含量也明显少于正常对照组，而Jagged-1 的表达水平明显升高(均P<0.05)。结论：MDS骨髓来源的MSC细胞体积增大、成骨分化能力明显减弱以及Jagged-1 的表达水平升高，可能在MDS造血功能衰竭和向急性髓系白血病转化的过程中发挥了重要作用。

Objective: To investigate the osteogenic differentiation characteristics of mesenchymal stem cell (MSC) derived from bone marrow in patients with myelodysplastic syndromes (MDS) and its clinical significance. Methods: Bone marrow samples from 30 cases of newly diagnosed untreated MDS patient at Affiliated Hospital of Heibei University were collected for this study. MSCs from MDS patients and normal subjects were isolated and cultured, and morphological characteristics of MSCs were observed in vitro; under proper conditions, MSCs were induced to differentiate into osteoblasts and adipocytes; The formation of calcium nodules at 14th day after osteogenic differentiation was observed by alizarin red staining; mRNA expressions of osteogenic differentiation transcription factors Ostefix and RUNX2 in undifferentiated MSCs, as well as the mRNA expression of Jagged-1, which involved in the transformation from hematopoietic cells into leukemic cells, were detected by quantitative PCR. Results: The MSCs derived from patients with MDS were characterized with increased cell volume and decreased differentiation potential. Compared with the control group, the expression levels of osteogenic differentiation transcription factors Osterix and RUNX2 were significantly decreased (P < 0.05). Alizarin red staining showed that the content of calcium nodules in MDS group was significantly less than that in the normal control group, while the expression level of Jagged-1 was significantly higher (P < 0.05). Conclusion: MSCs derived from bone marrow of MDS patients showed significant increased cell volume, decreased differentiation potential and elevated Jagged-1 expression; all of these might play important roles in the .hematopoietic failure and progression to acute myeloid leukemia in MDS patients.

广东省科技计划项目资助（No. 2017B020230004）