机构地区:[1]中国医学科学院中国协和医科大学血液学研究所血液病医院实验血液学国家重点实验室,天津300020
出 处:《中华医学杂志》2006年第10期669-673,共5页National Medical Journal of China
基 金:人事部留学回国人员基金资助项目
摘 要:目的探讨慢性特发性血小板减少性紫癜(ITP)患者Ⅰ类和Ⅱ类T细胞的特点。方法采取30例慢性ITP患者外周血及8例慢性ITP患者和6例遗传性球形红细胞增多症患者的脾细胞(接受脾切除的患者),应用流式细胞仪技术检测辅助T细胞(Th)CD4+和细胞毒性T细胞(Tc)CD8+胞质内细胞因子干扰素γ(IFNγ)/白细胞介素(IL)4的比例;应用实时定量聚合酶链反应(PCR)检测Tbet和GATA3mRNA的表达水平。结果疾病活动期患者外周血Th1/Th2和Tc1/Tc2的比例(25.62和30.23)显著高于正常对照组(8.29和12.58,均P<0.01);缓解期患者外周血Th1/Th2和Tc1/Tc2的比例(9.86和10.10)与正常对照组相比,差异无统计学意义。ITP患者脾细胞Th1/Th2的比例(41.46)显著高于对照组(16.30,P<0.01);Tc1/Tc2的比例(35.80)高于对照组(16.88),但差异无统计学意义。疾病活动期患者外周血以及ITP患者脾细胞GATA3mRNA水平明显低于对照组(是对照组的0.20和0.34倍,均P<0.05),缓解期患者与对照组相比,差异无统计学意义(是对照组的0.97倍)。ITP患者外周血及脾细胞TbetmRNA的表达水平与对照组相比,差异无统计学意义(是对照组的1.17和1.04倍)。结论ITP是Ⅰ类T细胞占优势的自身免疫性疾病。促进Ⅰ类T细胞模式向Ⅱ类T细胞转化可能为ITP患者提供一种潜在的免疫治疗方式。Objective To explore the profiles of type 1 and type 2 T cells in chronic idiopathic thrombocytopenic purpura (ITP) patients. Methods Samples of peripheral blood were collected from 30 chronic ITP patients, 8 males and 22 females, aged 34, 20 being in the active stage, and 10 in the remission stage, and 20 healthy persons, 7 males and 13 females, aged 31. Peripheral blood mononuclear cells (PBMCs) were isolated, cultured, and activated with PMA/ionomycin. Flow cytometry was used to measure the intracellular cytokines interferon (IFN)-γ and interleukin (IL)-4 in the PBMCs so as to identify the Th1 cells (IFN-γ^+L-4^+ CD4^+ cells) , Th2 cells (IFN-γ^-L-4^+ CD4^+ cells), Tc1 cells ( IFN-γ^+L- 4^- CD8^+ cells), and Tc2 cells ( IFN-γ^- IL-4^+ CD8^+ ceils). The ratios of Th2/Tc2, Th1/Th2, and Tc1/ Tc2 were calculated. Samples of spleen tissue were collected from 8 patients with chronic ITP, 3 males and 5 females, aged 30, and 6 patients with hereditary splenocytosis (HS), 3 males and 3 females, aged 35, who underwent splenectomy. Splenocytes were isolated, cultured, and activated with PMA/ionomycin. Realtime PCR was used to detect the mRNA expression of T-bet and GATA-3 in the PBMCs and splenocytes. Results The Th1/Th2 ratio of the patients in active stage was 25.62, significantly higher than those of the patients in remission stage (9. 86) and the control (8. 29, both P 〈 0. 01 ), and the Tc1/Tc2 ratio of the patients in active stage was 30. 23, significantly higher than those of the patients in remission stage ( 10. 10) and the controls ( 12. 58, both P 〈 0. 01 ). The Th1/Th2 ratio of the splenocytes of the patients in active stage was 41.46, significantly higher than that of the controls ( 16. 30, P 〈0. 01 ), and the Tc1/Tc2 ratio of the splenocytes of the active ITP patients was 35. 80, not significantly higher than that of the controls (16. 30, P = 0. 082). The GATA-3 mRNA expression level of the PBMCs of the active ITP patien
关 键 词:紫癜 血小板减少性 特发性 T淋巴细胞 干扰素Ⅱ型
分 类 号:R554.6[医药卫生—血液循环系统疾病] R47[医药卫生—内科学]
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