滤泡辅助性T细胞亚群在慢性特发性血小板减少性紫癜患儿发病机制中的作用分析
|
摘要
目的探索滤泡辅助性T细胞(Tfh)在慢性特发性血小板减少性紫癜(ITP)患儿中的作用机制。方法用流式细胞术检测38名健康儿童、35例ITP患儿外周血CXCR5+CD4+T细胞占CD4+T细胞的比例。采用酶联免疫吸附试验检测健康儿童、ITP患儿血浆白细胞介素-21(IL-21)浓度。结果与健康对照组相比,ITP患儿外周血CXCR5+CD4+T细胞占CD4+T细胞的比例显著增高[(13.86±7.53)%,(7.65±5.36)%,P<0.05]。经过激素治疗后,ITP患儿外周血中CXCR5+CD4+T细胞占CD4+T细胞比例有所下降[(13.8±0.41)%,(8.23±6.12)%,P<0.05]。初发ITP患儿外周血血浆IL-21浓度显著高于健康对照组[(80.47±25.79)μg/mL,(32.41±17.53)μg/mL,P<0.05]。经过激素治疗后,ITP患儿外周血血浆IL-21浓度有所下降,但两者差异无统计学意义[(80.47±25.79)μg/mL,(60.35±19.54)μg/mL,P>0.05]。结论慢性ITP患儿与健康对照组相比,存在Tfh细胞数量及功能异常,可能与慢性ITP的发病相关。
Objective To investigate the expression of the T follicular helper cells(Tfh) in peripheral blood of children with immune thrombocytopenic purpura(ITP). Methods Thirty-five children with ITP and 38 healthy children(control group) were enrolled in this study. The proportion of CXCR5+CD4+T cells of children with ITP and healthy controls in peripheral blood were analyzed by flow cytometry. The concentration of plasma IL-21 was determined by ELISA. Results The ratio of CXCR5+CD4+T cells in ITP children is significantly higher than that in the control group [(13.86±7.53)% vs(7.65±5.36)%, P<0.05], but decreased after the treatment of dexamethason for 30 days [(13.8±0.41)% vs(8.23±6.12)% P<0.05]. In contrast to the healthy controls, the concentration of cytokine IL-21 was significantly elevated in patients with ITP [(80.47±25.79) μg/mL vs(32.41±17.53) μg/mL P<0.05], but there is no significant change of cytokine IL-21 after the treatment of dexamethason for 30 days [(80.47±25.79) μg/mL vs(60.35±19.54) μg/mL P>0.05]. Conclusion The ratio of Tfh increased in ITP patients. Tfh might play a role in evaluation and treatment of ITP.
Objective To investigate the expression of the T follicular helper cells(Tfh) in peripheral blood of children with immune thrombocytopenic purpura(ITP). Methods Thirty-five children with ITP and 38 healthy children(control group) were enrolled in this study. The proportion of CXCR5+CD4+T cells of children with ITP and healthy controls in peripheral blood were analyzed by flow cytometry. The concentration of plasma IL-21 was determined by ELISA. Results The ratio of CXCR5+CD4+T cells in ITP children is significantly higher than that in the control group [(13.86±7.53)% vs(7.65±5.36)%, P<0.05], but decreased after the treatment of dexamethason for 30 days [(13.8±0.41)% vs(8.23±6.12)% P<0.05]. In contrast to the healthy controls, the concentration of cytokine IL-21 was significantly elevated in patients with ITP [(80.47±25.79) μg/mL vs(32.41±17.53) μg/mL P<0.05], but there is no significant change of cytokine IL-21 after the treatment of dexamethason for 30 days [(80.47±25.79) μg/mL vs(60.35±19.54) μg/mL P>0.05]. Conclusion The ratio of Tfh increased in ITP patients. Tfh might play a role in evaluation and treatment of ITP.
引文
[1]伍星.免疫性血小板减少患者T细胞免疫状态[J].中国免疫学杂志,2010,26(11):1045-1047.
[2]中华医学会儿科学分会血液学组,《中华儿科杂志》编辑委员会.儿童原发性免疫性血小板减少症诊疗建议[J].中华儿科杂志,2013,51(5):382-384.
[3] Wei Y,Ji XB,Wang YW,et al. High-dose dexamethasone us prednisone for treatment of adult immune thrombocytopenia:a prospective multicenter randomized trial[J]. Blood,2016,127(3):296-302.
[4] Zhou H,Qiu JH,Wang T,et al. Interleukin 27 inhibits cytotoxic T-lymphocyte-mediated platelet destruction in primary immune thrombocytopenia[J]. Blood,2014,124(22):3316-3319.
[5] Cines DB,McMillan R. Pathogenesis of chronic immune thrombocytopenic purpura[J]. Curr Opin Hematol,2007,14(5):511-514.
[6] King C,Tangye SG,Mackay CR. T follicular helper(TFH)cells in normal and dysregulated immune responses[J]. Annu Rev Immunol,2008,26:741-766.
[7] Bryant VL,Ma CS,Avery DT,et al. Cytokine-mediated regulation of human B cell differentiation into Ig-secreting cells:predominant role of IL-21 produced by CXCR5+Tfollicular helper cells[J]. J Immunol,2007,179(12):8180-8190.
[8] Ettinger R,Sims GP,Fairhurst AM,et al. IL-21 induces differentiatian of human naive and memory B cells into antibody-secreting plasma cells[J]. Immunol,2005,175:7867-7879.
[9] Kusam S,Toney LM,Sato H,et al. Inhibition of Th2 differentiation and GATA-3 expression by BCL-6[J]. Immunol,2003,170(5):2435-2441.
[10] Webster ML,Sayeh E,Ni H,et al. Relative efficacy of intra-venous immunoglobulin G in ameliorating thrombocytopenia induced by antiplatelet GPⅡbⅢa versus GPⅠbalpha antibodies[J]. Blood,2006,108(3):943-946.
[2]中华医学会儿科学分会血液学组,《中华儿科杂志》编辑委员会.儿童原发性免疫性血小板减少症诊疗建议[J].中华儿科杂志,2013,51(5):382-384.
[3] Wei Y,Ji XB,Wang YW,et al. High-dose dexamethasone us prednisone for treatment of adult immune thrombocytopenia:a prospective multicenter randomized trial[J]. Blood,2016,127(3):296-302.
[4] Zhou H,Qiu JH,Wang T,et al. Interleukin 27 inhibits cytotoxic T-lymphocyte-mediated platelet destruction in primary immune thrombocytopenia[J]. Blood,2014,124(22):3316-3319.
[5] Cines DB,McMillan R. Pathogenesis of chronic immune thrombocytopenic purpura[J]. Curr Opin Hematol,2007,14(5):511-514.
[6] King C,Tangye SG,Mackay CR. T follicular helper(TFH)cells in normal and dysregulated immune responses[J]. Annu Rev Immunol,2008,26:741-766.
[7] Bryant VL,Ma CS,Avery DT,et al. Cytokine-mediated regulation of human B cell differentiation into Ig-secreting cells:predominant role of IL-21 produced by CXCR5+Tfollicular helper cells[J]. J Immunol,2007,179(12):8180-8190.
[8] Ettinger R,Sims GP,Fairhurst AM,et al. IL-21 induces differentiatian of human naive and memory B cells into antibody-secreting plasma cells[J]. Immunol,2005,175:7867-7879.
[9] Kusam S,Toney LM,Sato H,et al. Inhibition of Th2 differentiation and GATA-3 expression by BCL-6[J]. Immunol,2003,170(5):2435-2441.
[10] Webster ML,Sayeh E,Ni H,et al. Relative efficacy of intra-venous immunoglobulin G in ameliorating thrombocytopenia induced by antiplatelet GPⅡbⅢa versus GPⅠbalpha antibodies[J]. Blood,2006,108(3):943-946.