特发性血小板减少性紫癜患者激素抵抗与Th1/Th2细胞因子表达的相关性研究  

The relationship between Th1/Th2 cytokine and glucocorticoidresistant idiopathic thrombocytopenia purpura

作　　者：赵艳红[1] 赵艳秋[1] 杨昆鹏[1] 张莹[1] 张卓[1] 周晋[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院血液内科,150001

出　　处：《国际免疫学杂志》2014年第2期161-164,共4页International Journal of Immunology

基　　金：黑龙江省教育厅科研项目（11531088）

摘　　要：目的 探讨特发性血小板减少性紫癜（ITP）患者糖皮质激素治疗效应与外周血单个核细胞（PBMC） Th1/Th2细胞因子表达水平之间的关系.方法 选取半定量RT-PCR的方法分别对ITP患者及正常对照组的Th1细胞因子IL-2、TNF-α、IFN-γ的mRNA和Th2细胞因子IL-4、IL-6的mRNA进行了检测;采用ELISA法检测ITP患者及对照组的血浆中的TNF-α含量.结果 IL-2、TNF-α、IFN-γ的mRNA表达量在ITP的患者（激素敏感和激素抵抗组）都明显高于正常对照组（IL-2：1.27±0.67和1.32 ±0.61比1.02±0.57;TNF-α：1.21±0.45和1.59±0.79比1.07±0.51;IFN-γ：1.28±0.49和1.35±0.57比1.11±0.45,P均＜0.05）;而IL-4、IL-6的mRNA表达量在ITP患者（激素敏感和激素抵抗组）低于正常对照组（IL-4：1.06±0.51和0.84±0.65比1.37±0.53;IL-6：1.04±0.61和0.98±0.57比1.31±0.52,P均＜0.05）;在ITP患者中,激素抵抗组的TNF-α mRNA的表达明显高于激素敏感组和正常对照组（1.59±0.79比1.21±0.45）,差异有统计学意义（P＜0.05）.ITP患者激素抵抗组和激素敏感组的TNF-α含量都明显高于正常对照组[（13.69±4.92） pg/mL和（19.73±4.66） pg/mL比（7.51±2.79）pg/mL,P＜0.05],而且激素抵抗组的TNF-α含量较激素敏感组增高[（13.69±4.92）pg/mL比（19.73±4.66） pg/mL,P＜0.05].结论 ITP患者表现为Th1细胞因子为主的表达,激素抵抗型ITP患者的TNF-α的表达增高.Objective To clarify the relationship between the response of the patients with idiopathic thrombocytopenia purpura （ITP）to glucocorticoid and Th1/Th2 cytokines in peroperal blood mononuclear cell （PBMC）.Methods Adult chronic ITP patients were divided to glucocorticoid-sensitive groups and glucocorticoidresistant groups according their responces to glucocorticoid.Healthy volunteers were regarded as controls.The semiquantitative RT-PCR was used to detect the expression of Th1/Th2 cytokines in PBMC.ELISA was used to detect the TNF-α in plasma.Results Compared with controls,the levels of Th1 type cytokines IL-2,TNF-α and IFN-γwere increased in ITP patients （IL-2：1.27 ± 0.67 and 1.32 ± 0.61 vs 1.02 ± 0.57 ;TNF-α：1.21 ± 0.45 and 1.59 ± 0.79 vs 1.07 ± 0.51 ; IFN-γ：1.28 ± 0.49 and 1.35 ± 0.57 vs 1.11 ± 0.45,all P 〈 0.05）,while the levels of Th2 type cytokines IL-4 and IL-6 were decreased in ITP patients （IL-4：1.06 ±0.51 and 0.84 ±0.65 vs 1.37 ±0.53;IL-6：1.04 ± 0.61 and 0.98 ± 0.57 vs 1.31 ± 0.52,all P 〈 0.05）.The expression of TNF-α in plasma of ITP patients with glucocorticoid resistance （19.73 ± 4.66） pg/mL was significantly higher than that in the glucocorticoid-sensitive groups （13.69 ± 4.92） pg/mL and controls （7.51 ± 2.79） pg/mL,all P 〈 0.05.Conclusions Imbalance of Th1/Th2 type cytokines may be correlated with the pathogenesis of ITP.

关 键 词：特发性血小板减少性紫癜 激素抵抗 TH1 TH2细胞因子 肿瘤坏死因子-Α TNF-α 

分 类 号：R554.6[医药卫生—血液循环系统疾病]