29例免疫性血小板减少性紫癜中调节性T细胞/Th17细胞的改变  

Regulatory T cells and Th17 cells in idiopathic thrombocytopenic purpura

作　　者：郭宁红[1] 石庆之[1] 华建媛[1] 

机构地区：[1]南昌大学第二附属医院血液内科,南昌330006

出　　处：《重庆医学》2011年第12期1150-1152,1155,共4页Chongqing medicine

摘　　要：目的探讨调节性T细胞/Th17细胞在免疫性血小板减少性紫癜(ITP)患者中的表达及意义。方法应用流式细胞术检测29例ITP患者和28例正常人外周血中的CD4+CD25+T细胞、CD4+CD25highT细胞(Treg)、CD4+IL-17A+T细胞(Th17)占总CD4+T细胞的比例,并评价其与血小板计数的相关性;酶联免疫吸附(ELISA)法测定血浆中IL-10I、L-17水平;RT-PCR法检测外周血Foxp3 mRNA、RORc mRNA的表达水平。结果与正常对照组比较,ITP患者组外周血CD4+CD25+T/CD4+T细胞比例升高(P<0.05)、Treg/CD4+T细胞比例明显下降(P<0.05),Th17/CD4+T细胞比例组间比较差异无统计学意义(P>0.05),Treg/Th17细胞比值明显降低(P<0.05)。ITP患者血浆中IL-10水平明显低于正常对照组(P<0.05),而IL-17水平与对照组比较差异无统计学意义(P>0.05)。ITP患者组较正常对照组外周血中转录因子Foxp3 mRNA水平明显降低(P<0.05),而RORc mRNA表达则较对照组明显升高(P<0.05)。Treg/CD4+T细胞比例及Treg/Th17细胞比值在效佳组显著高于效差组(P<0.05),Th17/CD4+T细胞比例效佳组显著低于效差组(P<0.05)。治疗前血小板计数与Treg/CD4+T细胞比例、Treg/Th17细胞比值成正相关(P<0.05),而与Th17/CD4+T细胞比例则无显著相关性(P>0.05)。结论 ITP患者存在Treg/Th17细胞平衡紊乱,T细胞亚群的功能失调可能与ITP免疫发病机制有关,并与糖皮质激素治疗效果有关。Objective To investigate the expression of regulatory T cells and Thl7 cells in idiopathic thrombocytopenic purpura （ITP） and its significance. Methods The quantity of CD4＋ CD25＋ T cells,CD4＋ CD25highT cells and CD4＋ IL-17＋T cells in peripheral blood were measured with the flow cytometry（FCM）,the plasma level of IL-10 and ILl7 with ELISA and the expression of Foxp3mRNA and RORc mRNA with RT PCR in 29 newly diagnosed ITP patients and 28 healthy controls. Results Compared with the normal controls, the ratio of CD4＋ CD25＋ T cells in the peripheral blood of patients with ITP was significantly higher （P〈 0.05）. And the rate of Treg cells in patients was remarkably lower （P〈0.05）. But there was no evident difference in the percentage of Th17 cells between ITP patients and control（P〉0.05）. However,the ratio of Treg/Th17 was lower in the ITP patients （P〈0.05）. The plasma level of IL-10 in ITP patients was found significantly decreased （P^0.05） ,whereas no statistical difference was observed in the level of IL17 （P〉0.05）. Furthermore,the Foxp3mRNA expression levels were largely reduced （P〈0.05）, but the RORe mRNA expression was increased than that in control（P〈0.05）. The proportion of Treg cells and Treg/Th17 in the effective therapy group was higher than that of in the ineffective therapy group（P〈0.05）, but the proportion of Thl7 cells was lower than that of in the ineffective therapy group （P〈0.05）. There was a significant correlation between platelet counts and Treg cells,Treg/Th17 in ITP patients （P〈0. 05）. The proportion of Th17 cells has no obvious correlation with platelet counts （ P〉0.05）. Conclusion The imbalance of Treg/Thl7 plays an important role in the pathogenesis of ITP.

关 键 词：T淋巴细胞 调节性 T淋巴细胞 辅助诱导 紫癜 血小板减少性 特发性 

分 类 号：R554.6[医药卫生—血液循环系统疾病]