成人免疫性血小板减少症中T淋巴细胞亚群失衡
Imbalance of T Lymphocyte Subsets in Adult Immune Thrombocytopenia.
作者信息
Lin Xiuxiu, Xu Anhui, Zhou Li, Zhao Na, Zhang Xinhui, Xu Jin, Feng Shanglong, Zheng Changcheng
机构信息
Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China.
Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China.
出版信息
Int J Gen Med. 2021 Mar 18;14:937-947. doi: 10.2147/IJGM.S298888. eCollection 2021.
BACKGROUND
Primary immune thrombocytopenia (ITP) is defined as an acquired autoimmune disease characterized by isolated thrombocytopenia. This work is to further clarify the relationship between T cell immune dysfunction and the pathogenesis of ITP.
METHODS
37 adult patients with ITP were selected and were classified into newly diagnosed ITP (nITP, n = 13), persistent ITP (pITP, n = 6) and chronic ITP (cITP n = 18). The frequency of cytotoxic T lymphocytes (Tc1, Tc2, and Tc17) and helper T cells (Th1, Th2, and Th17), Tregs, and the expression of chemokine receptors and PD-1 on CD4 T cells were investigated by flow cytometry. Plasma levels of T cell-related cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, IL-17) were measured by cytometric beads array (CBA).
RESULTS
The percentage of Tc1 in cITP was greatly higher than nITP and healthy controls ( < 0.05, < 0.01). The percentage of Treg in nITP and cITP groups was remarkably lower than those in healthy control group ( < 0.05, < 0.001); and according to platelet count analysis (PLT<50x10/L or PLT>50x10/L), Treg cells in ITP group were significantly lower than those in healthy control group ( < 0.001, < 0.05). The percentage of CD4CXCR3 of cITP was significantly higher than healthy controls and nITP ( < 0.01, < 0.05). The percentage of CD4CCR6 in cITP was significantly higher than healthy controls and nITP ( < 0.001, < 0.05). The expression of PD-1 in cITP patients was higher than healthy control ( < 0.05), but there was no significant difference among nITP, pITP and cITP ( = 0.25). The levels of IL-2, IFN-γ and TNFα in nITP group and cITP group were significantly higher than those in healthy control group ( < 0.01, < 0.05; < 0.01, < 0.05; < 0.05, < 0.05), and the level of IL-10 in nITP group was significantly higher than that in pITP group ( < 0.05).
CONCLUSION
Our results suggest that T lymphocyte immune dysfunction does exist in adult ITP patients and plays an important role in the pathogenesis of ITP.
背景
原发性免疫性血小板减少症（ITP）被定义为一种以孤立性血小板减少为特征的获得性自身免疫性疾病。本研究旨在进一步阐明T细胞免疫功能障碍与ITP发病机制之间的关系。
方法
选取37例成年ITP患者，分为新诊断ITP（nITP，n = 13）、持续性ITP（pITP，n = 6）和慢性ITP（cITP，n = 18）。采用流式细胞术检测细胞毒性T淋巴细胞（Tc1、Tc2和Tc17）、辅助性T细胞（Th1、Th2和Th17）、调节性T细胞（Tregs）的频率以及趋化因子受体和PD-1在CD4 T细胞上的表达。采用细胞计数珠阵列（CBA）检测血浆中T细胞相关细胞因子（IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ、IL-17）水平。
结果
cITP组中Tc1的百分比显著高于nITP组和健康对照组（P<0.05，P<0.01）。nITP组和cITP组中Treg的百分比显著低于健康对照组（P<0.05，P<0.001）；根据血小板计数分析（PLT<50x10⁹/L或PLT>50x10⁹/L），ITP组中Treg细胞显著低于健康对照组（P<0.001，P<0.05）。cITP组中CD4⁺CXCR3的百分比显著高于健康对照组和nITP组（P<0.01，P<0.05）。cITP组中CD4⁺CCR6的百分比显著高于健康对照组和nITP组（P<0.001，P<0.例）。cITP患者中PD-1的表达高于健康对照组（P<0.05），但nITP、pITP和cITP之间无显著差异（P = 0.25）。nITP组和cITP组中IL-2、IFN-γ和TNFα水平显著高于健康对照组（P<0.01，P<0.05；P<0.01，P<0.05；P<0.05，P<0.05），nITP组中IL-10水平显著高于pITP组（P<0.05）。
结论
我们的结果表明，成年ITP患者确实存在T淋巴细胞免疫功能障碍，且在ITP发病机制中起重要作用。
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