Zhu Ying, Zhuang Yun, Yang Guo-Hua, Qiang Xi-Feng, Yang Lei, Shen Yun-Feng
Department of Hematology, Nanjing Medical University, Wuxi, Jiangsu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Feb;21(1):135-9. doi: 10.7534/j.issn.1009-2137.2013.01.028.
This study was aimed to investigate the correlation of FcγR polymorphisms with the susceptibility, severity and efficacy of immunotherapy for patients with immune thrombocytopenia (ITP). PCR and DNA sequencing were used to determine the polymorphisms of FcγRIIA, FcγRIIIA and FcγRIIB in 44 ITP patients, and in 97 healthy control subjects. The results indicated that FcγRIIIA-158V/F polymorphisms between patients and controls were statistically significantly different (P = 0.015); among FcγRIIIA genotypes, the frequency of 158V/V homotype was higher in ITP (P = 0.005). However, the FcγRIIA-131H/R or FcγRIIB-232T/I polymorphisms were not significantly different between patients and controls; there were no correlation of FcγRIIA, FcγRIIIA and FcγRIIB genotype frequencies with the platelet counts or the courses of ITP; among the 38 ITP patients who received treatments, the complete response (CR) rate was 42% (16/38), and partial response (PR) rate was 34% (13/38). The therapeutic response was significantly different between FcγRIIIA-158V/V homotype and 158F/V heterotype (P = 0.034). The CR of patients with 158V/V homotype was obviously lower than that of patients with 158F/V, but the frequencies of FcγRIIA and FcγRIIB genotypes not correlated with the responsiveness to treatment. The CR rate of 6 patients treated with rituximab was 67%, and PR rate was 17%. The overall response rate was as high as 84%, the adverse reactions were not observed. It is concluded that the polymorphism of FcγRIIIA-158V/F, but not FcγRIIA-131H/R or FcγRIIB-232T/I, correlates with the patient susceptibility and therapeutic response of ITP.
本研究旨在探讨FcγR基因多态性与免疫性血小板减少症（ITP）患者的易感性、疾病严重程度及免疫治疗疗效之间的相关性。采用聚合酶链反应（PCR）和DNA测序技术，对44例ITP患者及97例健康对照者的FcγRIIA、FcγRIIIA和FcγRIIB基因多态性进行检测。结果显示，患者与对照者之间FcγRIIIA - 158V/F基因多态性存在统计学显著差异（P = 0.015）；在FcγRIIIA基因各基因型中，158V/V纯合子在ITP患者中的频率较高（P = 0.005）。然而，患者与对照者之间FcγRIIA - 131H/R或FcγRIIB - 232T/I基因多态性无显著差异；FcγRIIA、FcγRIIIA和FcγRIIB基因型频率与ITP患者的血小板计数或病程无相关性；在38例接受治疗的ITP患者中，完全缓解（CR）率为42%（16/38），部分缓解（PR）率为34%（13/38）。FcγRIIIA - 158V/V纯合子与158F/V杂合子患者的治疗反应存在显著差异（P = 0.034）。158V/V纯合子患者的CR率明显低于158F/V患者，但FcγRIIA和FcγRIIB基因型频率与治疗反应性无关。6例接受利妥昔单抗治疗的患者CR率为67%，PR率为17%。总体有效率高达84%，未观察到不良反应。结论是，与ITP患者易感性及治疗反应相关的是FcγRIIIA - 158V/F基因多态性，而非FcγRIIA - 131H/R或FcγRIIB - 232T/I基因多态性。
