Wang Ying-Chao, Liu Man-Ju, Zhu Gui-Ying, Wang Jun-Bo, Jiang Lan-Jun
Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2016 Mar;18(3):238-42. doi: 10.7499/j.issn.1008-8830.2016.03.010.
To investigate the significance of Th17/Treg imbalance in the development and treatment of primary immune thrombocytopenia (ITP) in children.
Thirty-two children diagnosed with ITP between May and August, 2015 and 22 healthy children were enrolled. Flow cytometry was used to determine the Th17/Treg ratio in peripheral blood of healthy children and children with ITP before and after treatment with immunoglobulin.
Compared with the patients with ITP before treatment, the healthy children and the patients treated with immunoglobulin had a significantly lower percentage of Th17 cells in CD4+ T cells, a significantly lower Th17/Treg ratio, and a significantly higher percentage of Treg cells in CD4+ T cells in peripheral blood (P<0.05). In the 32 ITP children treated with immunoglobulin, 20 had complete response, 4 had response, and 8 had no response. The patients with complete response had a significantly lower percentage of Th17 cells in CD4+ T cells and a significantly lower Th17/Treg ratio in peripheral blood than the patients without response (P<0.05).
The Th17/Treg imbalance can be found in children with ITP. Immunoglobulin can improve the cellular immune function by regulation of the Th17/Treg ratio. The Th17/Treg ratio may serve as an indicator for assessing the therapeutic effects of ITP.
探讨Th17/Treg失衡在儿童原发性免疫性血小板减少症（ITP）发生发展及治疗中的意义。
选取2015年5月至8月诊断为ITP的32例儿童及22例健康儿童。采用流式细胞术检测健康儿童及ITP患儿免疫球蛋白治疗前后外周血中Th17/Treg比值。
与ITP未治疗患儿相比，健康儿童及免疫球蛋白治疗后的患儿外周血CD4+T细胞中Th17细胞百分比显著降低，Th17/Treg比值显著降低，CD4+T细胞中Treg细胞百分比显著升高（P<0.05）。32例接受免疫球蛋白治疗的ITP患儿中，20例完全缓解，4例部分缓解，8例无反应。完全缓解患儿外周血CD4+T细胞中Th17细胞百分比及Th17/Treg比值显著低于无反应患儿（P<0.05）。
ITP患儿存在Th17/Treg失衡。免疫球蛋白可通过调节Th17/Treg比值改善细胞免疫功能。Th17/Treg比值可作为评估ITP治疗效果的指标。
