Zhan Yanxia, Zou Shanhua, Hua Fanli, Li Feng, Ji Lili, Wang Weiguang, Ye Yi, Sun Lihua, Chen Hao, Cheng Yunfeng
Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Immunol Lett. 2014 Jul;160(1):33-38. doi: 10.1016/j.imlet.2014.03.002. Epub 2014 Mar 18.
Primary immune thrombocytopenia (ITP) is an autoimmune heterogeneous disorder which is characterized by decreased platelet count. Serum cytokines play an important role in the pathogenesis of ITP by initiating and perpetuating various cellular and humoral autoimmune processes. To investigate a broad spectrum of cytokines in ITP patients and the effects of high-dose dexamethasone (HD-DXM) regimen on serum cytokines profile, a multiplex cytokine assay was used to measure the serum levels of 20 circulating cytokines simultaneously in 22 patients before and after oral administration of 40mg/day DXM for 4 consecutive days. A cohort of 10 healthy individuals was served as control. Serum levels of interleukin (IL)-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, growth-related oncogene (GRO), interferen (IFN)-γ and tumor necrosis factor (TNF)-α were significantly decreased in pre-treatment patients, compared with healthy controls (p<0.05). After HD-DXM treatment, IL-4, IL-5, IL-6, IL-12p70, IL-13, GRO, IFN-γ and TNF-α were significantly increased in remission patients as compared with patients before treatment (p<0.05). However, there was no significant difference (except TNF-α) between remission patients and healthy controls (p>0.05). All these cytokines decreased again in relapse patients. Our findings suggest that measuring cytokine levels might help in the clinical assessment of ITP, and the HD-DXM therapy could correct the derangement of serum cytokines.
原发性免疫性血小板减少症(ITP)是一种自身免疫性异质性疾病,其特征为血小板计数减少。血清细胞因子通过启动和维持各种细胞及体液自身免疫过程,在ITP的发病机制中发挥重要作用。为了研究ITP患者体内广泛的细胞因子以及大剂量地塞米松(HD-DXM)方案对血清细胞因子谱的影响,采用多重细胞因子检测法同时测定了22例患者在连续4天口服40mg/天DXM前后20种循环细胞因子的血清水平。选取10名健康个体作为对照组。与健康对照组相比,治疗前患者的白细胞介素(IL)-4、IL-5、IL-6、IL-10、IL-12p70、IL-13、生长相关癌基因(GRO)、干扰素(IFN)-γ和肿瘤坏死因子(TNF)-α血清水平显著降低(p<0.05)。HD-DXM治疗后,缓解患者的IL-4、IL-5、IL-6、IL-12p70、IL-13、GRO、IFN-γ和TNF-α水平与治疗前患者相比显著升高(p<0.05)。然而,缓解患者与健康对照组之间(除TNF-α外)无显著差异(p>0.05)。复发患者中所有这些细胞因子水平再次下降。我们的研究结果表明,检测细胞因子水平可能有助于ITP的临床评估,且HD-DXM疗法可纠正血清细胞因子的紊乱。
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