Tong Huan, Ding Yangyang, Gui Xiang, Sun Zengtian, Wang Guozhang, Zhang Sixuan, Xu Zhengqing, Wang Xiamin, Xu Xiaoqi, Ju Wen, Li Yue, Li Zhenyu, Zeng Lingyu, Xu Kailin, Qiao Jianlin
Blood Diseases Institute, Xuzhou Medical University, 84 West Huaihai Road, Quanshan District, Xuzhou, 221002, Jiangsu, China.
Department of Hematology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China.
Thromb J. 2021 Aug 28;19(1):61. doi: 10.1186/s12959-021-00314-6.
Immune thrombocytopenia (ITP) is an autoimmune disease characterized as a low platelet count resulting from immune-mediated platelet destruction. Dimethyl fumarate (DMF) is widely applied for the treatment of several autoimmune diseases with immunosuppressive effect. However, whether it ameliorates ITP is unclear. This study aims to evaluate whether DMF has a preventive effect on ITP in mice.
DMF (30, 60 or 90 mg/kg body weight) was intraperitoneally injected into mice followed by injection of rat anti-mouse integrin GPIIb/CD41antibody to induce ITP. Peripheral blood was isolated to measure platelet count and spleen mononuclear cells were extracted to measure Th1 and Treg cells along with detecting the levels of IFN-γ, and TGFβ-1 in plasma and CD68 expression in spleen by immuohistochemical staining. Additionally, macrophage cell line RAW264.7 was cultured and treated with DMF followed by analysis of cell apoptosis and cycle, and the expression of FcγRI, FcγRIIb and FcγRIV mRNA.
DMF significantly inhibited antiplatelet antibody-induced platelet destruction, decreased Th1 cells and the expression of T-bet and IFN-γ, upregulated Treg cells and the expression of Foxp3 and TGF-β1 as well as reduced CD68 expression in the spleen of ITP mouse. DMF-treated RAW264.7 cells showed S-phase arrest, increased apoptosis and downregulated expression of FcγRI and FcγRIV. Meanwhile, in vitro treatment of DMF also decreased the expression of cyclin D1 and E2, reduced Bcl-2 level and increased Bax expression and caspase-3 activation.
In conclusion, DMF prevents antibody-mediated platelet destruction in ITP mice possibly through promoting apoptosis, indicating that it might be used as a new approach for the treatment of ITP.
免疫性血小板减少症(ITP)是一种自身免疫性疾病,其特征为免疫介导的血小板破坏导致血小板计数降低。富马酸二甲酯(DMF)广泛应用于治疗多种具有免疫抑制作用的自身免疫性疾病。然而,其是否能改善ITP尚不清楚。本研究旨在评估DMF对小鼠ITP是否具有预防作用。
将DMF(30、60或90mg/kg体重)腹腔注射到小鼠体内,随后注射大鼠抗小鼠整合素GPIIb/CD41抗体以诱导ITP。采集外周血以测量血小板计数,提取脾脏单核细胞以测量Th1和调节性T细胞(Treg),同时通过免疫组化染色检测血浆中干扰素-γ(IFN-γ)和转化生长因子β-1(TGFβ-1)的水平以及脾脏中CD68的表达。此外,培养巨噬细胞系RAW264.7并用DMF处理,然后分析细胞凋亡和周期以及FcγRI、FcγRIIb和FcγRIV mRNA的表达。
DMF显著抑制抗血小板抗体诱导的血小板破坏,减少Th1细胞以及T-bet和IFN-γ的表达,上调Treg细胞以及叉头框蛋白3(Foxp3)和TGF-β1的表达,并降低ITP小鼠脾脏中CD68的表达。经DMF处理的RAW264.7细胞出现S期阻滞,细胞凋亡增加,FcγRI和FcγRIV的表达下调。同时,DMF的体外处理还降低了细胞周期蛋白D1和E2的表达,降低了Bcl-2水平,增加了Bax表达和半胱天冬酶-3(caspase-3)的激活。
总之,DMF可能通过促进凋亡来预防ITP小鼠中抗体介导的血小板破坏,表明其可能成为治疗ITP的一种新方法。