儿童免疫性血小板减少症中 T 细胞活化标志物的过度表达。

Excessive expressions of T cell activation markers in pediatric immune thrombocytopenia.

机构信息

Division of Hematology-oncology, Children's Hospital of Zhejiang University School of Medicine, #57 Zhuganxiang Road, Hangzhou 310003, PR China.

出版信息

Thromb Res. 2019 Aug;180:1-9. doi: 10.1016/j.thromres.2019.05.010. Epub 2019 May 15.

DOI:10.1016/j.thromres.2019.05.010

PMID:31146120

Abstract

BACKGROUND

Immune thrombocytopenia (ITP) is an immune-mediated bleeding disorder in children. Activated T cells have been shown to play important roles in ITP. The aims of this study were to evaluate whether these T cell activation markers could be used as indicators to differentiate ITP patients from controls, and to assess whether they could be used as predictors of IVIG response in ITP patients.

METHODS

A cohort of 92 hospitalized ITP patients, 49 unrelated healthy children, and 48 thrombocytosis patients were enrolled in this retrospective study between February 2013 and September 2018. Expression of CD25, HLA-DR, and CD69 on the surfaces of CD4+ and CD8+ T cells were detected by flow cytometry. All statistical analyses were performed using SPSS 20.0 software.

RESULTS

Compared to the healthy controls, ITP patients had higher percentages of CD4 + CD25+ T cells, CD4 + HLA-DR+ T cells, CD8 + HLA-DR+ T cells, and CD8 + CD69+ T cells. Compared to the thrombocytosis patients, ITP patients had higher percentages of CD4 + HLA-DR+ T cells and CD8 + HLA-DR+ T cells, and lower CD4 + CD69+ T cells and CD8 + CD69+ T cells. Platelet count at admission had a negative correlation with CD4 + CD25+ T cells in ITP. CD4 + CD69+ T cells were decreased in chronic compared to the newly diagnosed and persistent ITP patients. Activated T cell markers had no predictive value for IVIG response in ITP patients.

CONCLUSIONS

T cell activation markers were excessively expressed in pediatric ITP, and those markers had no predictive value for IVIG response in ITP patients.

摘要

背景

免疫性血小板减少症（ITP）是一种儿童期的免疫介导性出血性疾病。已证实活化的 T 细胞在 ITP 中发挥重要作用。本研究旨在评估这些 T 细胞活化标志物是否可作为区分 ITP 患者与对照者的指标，并评估其是否可作为 ITP 患者对 IVIG 反应的预测指标。

方法

本回顾性研究纳入了 2013 年 2 月至 2018 年 9 月期间住院的 92 例 ITP 患儿、49 例无关健康儿童和 48 例血小板增多症患者。采用流式细胞术检测 CD4+和 CD8+T 细胞表面 CD25、HLA-DR 和 CD69 的表达。所有统计分析均使用 SPSS 20.0 软件进行。

结果

与健康对照者相比，ITP 患儿的 CD4+CD25+T 细胞、CD4+HLA-DR+T 细胞、CD8+HLA-DR+T 细胞和 CD8+CD69+T 细胞比例更高。与血小板增多症患者相比，ITP 患儿的 CD4+HLA-DR+T 细胞和 CD8+HLA-DR+T 细胞比例更高，而 CD4+CD69+T 细胞和 CD8+CD69+T 细胞比例更低。ITP 患儿入院时血小板计数与 CD4+CD25+T 细胞呈负相关。与新发和持续性 ITP 患者相比，慢性 ITP 患者的 CD4+CD69+T 细胞减少。活化 T 细胞标志物对 ITP 患者 IVIG 反应无预测价值。