Wu Chang-Lin, Wang Qian, Zheng Lei, Gu Da-Yong, He Jian-An, Shao Chao-Peng
Postgraduate College of South Medical University,Guangzhou 510515, Guangdong Province, China; Department of Blood Transfusion of Shenzhen Municipal Second People's Hospital, Shenzhen 518035, Guangdong Province, China.
Laboratory Examination Center,Affiliated South Hospital of South Medical University, Guangzhou 510511,Guangdong Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Dec;21(6):1517-21. doi: 10.7534/j.issn.1009-2137.2013.06.028.
This study was aimed to detect the level of the peripheral blood Breg and CD4(+) T cell subgroups in patients with chronic idiopathic thrombocytopenic purpura (CITP) before and after therapy, and to analyse the charge of related cytokines and their correlation, to explore their roles in the pathogenesis of CITP. A total of 35 CITP cases were taken as the research group and 35 healthy persons were served as the control group. The peripheral blood mononuclear cells (PBMNC) were separated, the percentages of Th1, Th17, Th22 and Breg cells were detected by flow cytometry before and after treatment of glucocorticoid, and the IFN-γ, IL-17, IL-22 and IL-10 levels from PBMNC culture supernatant also were determined by ELISA. The results showed that there was significant difference as compared with the healthy controls, the proportion of peripheral blood Th1, Th17, Th22 cell subgroups all increased in CITP patients before treatment with glucocorticoid, the regulatory B cells (Breg) ratio was reduced, the differences had statistical significance (P < 0.05), but the differences were no statistically significant after treatment with glucocorticoid (P > 0.05). The levels of IFN-γ, IL-17, IL-22 from culture supernatant all increased in CITP patients before treatment, the level of IL-10 was lower than that of the healthy control, the difference was statistically significant (P < 0.05), but the there were no statistically significant differences after treatment (P > 0.05). There were positive correlation between the Breg cells and IL-10 expression in CITP patients (P < 0.05), the Breg cells and Th1, Th17, Th22 cells showed a negative correlation, IL-10 and IFN-γ, IL-17, IL-22 levels also showed a negative correlation. It is concluded that the down-regulation of regulatory B cells proportion and the IL-10 level may participate in the mechanism of CD4(+) T cell immunity disorder in CITP, which can provide new targets and ideas for the clinical immune regulation therapy.
本研究旨在检测慢性特发性血小板减少性紫癜（CITP）患者治疗前后外周血调节性B细胞（Breg）及CD4(+) T细胞亚群水平，分析相关细胞因子变化及其相关性，探讨其在CITP发病机制中的作用。选取35例CITP患者作为研究组，35例健康人作为对照组。分离外周血单个核细胞（PBMNC），采用流式细胞术检测糖皮质激素治疗前后Th1、Th17、Th22及Breg细胞百分比，采用酶联免疫吸附测定法（ELISA）检测PBMNC培养上清液中干扰素-γ（IFN-γ）、白细胞介素-17（IL-17）、白细胞介素-22（IL-22）及白细胞介素-10（IL-10）水平。结果显示，与健康对照组相比差异有统计学意义，CITP患者糖皮质激素治疗前外周血Th1、Th17、Th22细胞亚群比例均升高，调节性B细胞（Breg）比例降低，差异有统计学意义（P < 0.05），糖皮质激素治疗后差异无统计学意义（P > 0.05）。CITP患者治疗前培养上清液中IFN-γ、IL-17、IL-22水平均升高，IL-10水平低于健康对照组，差异有统计学意义（P < 0.05），治疗后差异无统计学意义（P > 0.05）。CITP患者Breg细胞与IL-10表达呈正相关（P < 0.05），Breg细胞与Th1、Th17、Th22细胞呈负相关，IL-10与IFN-γ、IL-17、IL-22水平也呈负相关。结论：调节性B细胞比例及IL-10水平下调可能参与CITP患者CD4(+) T细胞免疫紊乱机制，可为临床免疫调节治疗提供新靶点和思路。
