Department of Hematology, Zhongshan Hospital Fudan University, Shanghai 200032, China.
Department of Hematology, Zhongshan Hospital Fudan University, Shanghai 200032, China; Department of Hematology, Zhongshan Hospital Qingpu Branch, Fudan Universiy, Shanghai 201700, China.
Thromb Res. 2019 Sep;181:10-16. doi: 10.1016/j.thromres.2019.07.001. Epub 2019 Jul 2.
Primary immune thrombocytopenia (ITP) is an autoimmune heterogeneous disorder of which Treg cells are numerically or functionally deficient. It is known that human FoxP3CD4 T cells were composed of 3 phenotypically and functionally distinct subpopulations (resting Treg, rTreg; activated Treg, aTreg; and non-suppressive Treg, n-sTreg). The current study was aimed to determine whether these Treg subtypes are altered in ITP patients and the related potential clinical applications.
Normal control volunteers and newly diagnosed ITP patients were enrolled in the study. The percentage of Treg cells' subtypes in peripheral blood was examined by flow cytometry before and after the glucocorticoid treatment. The IL-10 production by Treg subtypes was also examined.
Treg cell subtypes of aTreg increased, rTreg decreased, and n-s Treg increased in newly diagnosed ITP patients' peripheral blood. The IL-10 production by respective Treg subtype didn't change after the treatment, and aTreg cells had the highest IL-10 yield. Patients who gained remission during follow-up had a higher aTreg cells' percentage than those who did not at the disease diagnosis.
Tregs cell subtypes percentage was altered when ITP occurred. The increased aTreg cells at disease diagnosis might predict a better glucocorticoid treatment efficacy.
原发免疫性血小板减少症（ITP）是一种自身免疫性异质性疾病，其 Treg 细胞在数量或功能上存在缺陷。已知人类 FoxP3+CD4+T 细胞由 3 种表型和功能上不同的亚群组成（静息 Treg 细胞，rTreg；活化 Treg 细胞，aTreg；和非抑制性 Treg 细胞，n-sTreg）。本研究旨在确定这些 Treg 亚群在 ITP 患者中是否发生改变，以及相关的潜在临床应用。
正常对照志愿者和新诊断的 ITP 患者被纳入研究。在糖皮质激素治疗前后，通过流式细胞术检测外周血中 Treg 细胞亚群的比例。还检测了 Treg 亚群的 IL-10 产生情况。
新诊断的 ITP 患者外周血中 aTreg 细胞亚群增加，rTreg 细胞减少，n-s Treg 细胞增加。治疗后，各 Treg 亚群的 IL-10 产生没有变化，而 aTreg 细胞具有最高的 IL-10 产量。在随访期间获得缓解的患者在疾病诊断时的 aTreg 细胞百分比高于未获得缓解的患者。
ITP 发生时 Treg 细胞亚群比例发生改变。疾病诊断时增加的 aTreg 细胞可能预示着糖皮质激素治疗效果更好。
