[免疫性血小板减少症患者血浆高迁移率族蛋白B1、干扰素-γ、白细胞介素-4及CD4T细胞表面Toll样受体4表达的意义]
[Significance of Plasma HMGB1, IFN-γ, IL-4 and TLR4 Expression on CD4T Cell Surface in Patients with Immune Thrombocytopenia].
作者信息
Dai Xin, Li Wen-Qian, Li Jian-Ping, Feng Jian-Ming
机构信息
Department of Hematology and Rheumatism, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China.
Department of Hematology and Rheumatism, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China. E-mail:
出版信息
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2016 Dec;24(6):1837-1841. doi: 10.7534/j.issn.1009-2137.2016.06.040.
OBJECTIVE
To investigate the effects of plasma HMGB1, IFN-γ, IL-4 and CD4T cell surface TLR4 expression on the immune thrombocytopenia(ITP).
METHODS
Twenty-five patients diagnosed as ITP in our hospital from October 2014 to October 2015, and 20 healthy persons as controls were selected. The ELISA was used to detect the plasma levels of HMGB1, IFN-γ and IL-4 in 2 groups; the flow cytometry was used to detect the expression level of TLR4 on the surface of CD4 cells. The relatienship between different parameters was analyzed.
RESULTS
Before treatment, the plasma HMGB1 level in ITP group was significantly higher than that in control group (t=4.259, P<0.01), while after treatment it significantly decreased and close to level in control group (t=1.267, P>0.05). The plasma IFN-γ level detected in ITP group before and after treatment was not significantly different from level in control group (P>0.05), while the IL-4 level in ITP group before treatment was significantly lower than that in control grup (t=2.107, P<0.05), but the IL-4 level in ITP group after treatment was significantly higher than that in control group (t=2.107, P<0.05). The plasma IFN-γ/IL-4 ratio in ITP group before treatment was significantly higher than that in control group (t=5.436, P<0.01), but it obviously decreased and was slightly lower than that in control group after treatment. The expression level of TLR4 in ITP group before and after treatment was all significantly lower than that in control group (P<0.01). The HMGB1 level in ITP group was directly proportional to the CD3 content (r=0.824, P<0.01), however it not significantly related with CD4 content (r=0.074, P>0.05), but than the HMGB1 level in ITP group was directly proportional to CD8 content (r=0.844, P<0.01) and to IL-4 content (r=0.784, P<0.01), and was inversely proportional to IFN-γ level(r=-0.814,P<0.01),and also was inversely proportional to IFN-γ /IL-4 ratio(r=-0.887,P<0.01),and directly proportional to TLR4 expression level(r=0.772,P<0.01).
CONCLUSION
The HMGB1 and TLR4 expression levels in ITP patients are higher, and clinical therapy can relieve the disease by targetly control in HMGB1 and TLR4 expression.
目的
探讨血浆高迁移率族蛋白B1（HMGB1）、干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）及CD4⁺T细胞表面Toll样受体4（TLR4）表达在免疫性血小板减少症（ITP）中的作用。
方法
选取2014年10月至2015年10月在我院确诊为ITP的患者25例，选取20例健康者作为对照。采用酶联免疫吸附测定（ELISA）法检测两组血浆HMGB1、IFN-γ及IL-4水平；采用流式细胞术检测CD4⁺细胞表面TLR4的表达水平。分析各参数之间的关系。
结果
治疗前，ITP组血浆HMGB1水平显著高于对照组（t = 4.259，P < 0.01），治疗后显著降低且接近对照组水平（t = 1.267，P > 0.05）。ITP组治疗前后检测的血浆IFN-γ水平与对照组水平差异无统计学意义（P > 0.05），而ITP组治疗前IL-4水平显著低于对照组（t = 2.107，P < 0.05），但ITP组治疗后IL-4水平显著高于对照组（t = 2.107，P < 0.05）。ITP组治疗前血浆IFN-γ/IL-4比值显著高于对照组（t = 5.436，P < 0.01），但治疗后明显降低且略低于对照组。ITP组治疗前后TLR4表达水平均显著低于对照组（P < 0.01）。ITP组HMGB1水平与CD3⁺含量呈正相关（r = 0.824，P < 0.01），然而与CD4⁺含量无明显相关性（r = 0.074，P > 0.05），但ITP组HMGB1水平与CD8⁺含量呈正相关（r = 0.844，P < 0.01），与IL-4含量呈正相关（r = 0.784，P < 0.01），与IFN-γ水平呈负相关（r = -0.814，P < 0.01），与IFN-γ/IL-4比值呈负相关（r = -0.887，P < 0.01），与TLR4表达水平呈正相关（r = 0.772，P < O.01）。
结论
ITP患者HMGB1及TLR4表达水平较高，临床治疗可通过针对性调控HMGB1及TLR4表达来缓解病情。
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