免疫性血小板减少症患者中B细胞活化因子及其受体与白细胞介素-21变化及相关性分析  

Changes of B cell activating factor/B cell activating factor receptor and interleukin-21 in patients with immune thrombocytopenia

作　　者：王宁[1] 朱效娟[2] 张峰[2] 姚庆民[2] 刘彦霞[2] 石艳[1] 马道新[1] 侯明[1] 彭军[1] 

机构地区：[1]山东大学齐鲁医院血液科,济南250012 [2]山东大学附属省立医院保健综合科

出　　处：《临床血液学杂志》2014年第3期400-403,共4页Journal of Clinical Hematology

基　　金：国家自然科学基金青年科学基金项目(No:81100335)

摘　　要：目的:检测免疫性血小板减少症(ITP)患者中B细胞活化因子(BAFF)、BAFF受体(BAFF-R)及白细胞介素-21(IL-21)的表达,并进行相关性分析,进一步探讨其临床意义。方法:应用酶联免疫吸附试验(ELISA)法检测18例ITP患者和15例对照者血浆BAFF和IL-21的表达;应用流式细胞术检测CD19+细胞上BAFF-R的表达及CD3+CD8-IL-21+和CD3+CD8+IL-21+细胞的比例。结果:活动性ITP患者血浆BAFF和IL-21水平均明显高于对照者[(589.9±201.9)pg/ml∶(424.5±164.2)pg/ml,(156.8±112.0)pg/ml∶(82.0±27.0)pg/ml,均P<0.05]。CD19+细胞均表达BAFF-R,且ITP患者中BAFF-R表达明显低于对照者[(45.1±10.4)∶(71.2±18.8),P<0.01]。发现IL-21表达于CD3+CD8-细胞和CD3+CD8+细胞上,ITP患者中CD3+CD8-IL-21+细胞亚群比例、CD3+CD8+IL-21+细胞亚群比例均显著高于对照者[(4.3±1.0)%∶(2.9±1.4)%,(1.0±0.6)%∶(0.6±0.3)%,均P<0.05]。血浆BAFF与IL-21存在正相关(P<0.01),BAFF-R与IL-21存在负相关(P<0.05)。结论:ITP患者中BAFF、IL-21表达均升高,且两者血浆水平之间存在正相关,BAFF-R与IL-21存在负相关,提示BAFF/BAFF-R信号通路与IL-21在ITP的发病中发挥重要作用。Objective：To investigate the expression and correlation of B cell activating factor（BAFF）,BAFF receptor（BAFF-R）and interleukin-21（IL-21）in immune thrombocytopenia（ITP）patients.Method：The expression of plasma BAFF and IL-21were measured by ELISA,the levels of CD3^＋CD8^-IL-21^＋,CD3^＋CD8^＋IL-21^＋ cells and BAFF-R in peripheral blood in ITP patients and controls were measured by flow cytometry.Result：Plasma BAFF and IL-21levels significantly elevated in ITP patients.BAFF-R expressed on all CD19^＋B lymphocytes by flow cytometry and BAFF-R mean fluorescence intensity on CD19^＋B lymphocytes decreased in ITP patients. The percentage of CD3^＋CD8^-IL-21^＋T cells and CD3^＋CD8^＋IL-21^＋T cells significantly increased in ITP patients compared to controls.More importantly,positive correlation between plasma BAFF and IL-21and negative correlation between BAFF-R and IL-21were found in ITP patients.Conclusion：Abnormal expression of BAFF/ BAFF-R and IL-21,and their correlation indicates possible collaborative role in the pathogenesis of ITP.

关 键 词：免疫性血小板减少症 B细胞活化因子 B细胞活化因子受体 白细胞介素-21 

分 类 号：R558.2[医药卫生—血液循环系统疾病]