免疫性血小板减少症患者骨髓滤泡辅助性T细胞数量及功能的研究  

Quantity and Function of T Follicular Helper Cells in the Bone Marrow of Patients with Immune Thrombocytopenia

作　　者：张洋[1] 瞿文[1] 阮二宝[1] 付蓉[1] 王国锦[1] 刘鸿[1] 王晓明[1] 吴玉红[1] 宋嘉[1] 邢莉民[1] 关晶[1] 李丽娟[1] 王化泉[1] 邵宗鸿[1] 

机构地区：[1]天津医科大学总医院血液科,天津300052

出　　处：《中国实验血液学杂志》2014年第3期758-761,共4页Journal of Experimental Hematology

基　　金：国家自然科学基金(81170472;81370607);天津市自然科学基金重点项目(12JCZDJC21500);天津市抗癌重大专项攻关计划(12ZCDZSY17900;12ZCDZSY18000);天津市卫生行业重点攻关项目(11KG135);卫生行业科研专项项目(201202017)

摘　　要：本研究检测免疫性血小板减少症(ITP)患者骨髓滤泡辅助性T细胞(Tfh细胞)数量及功能,探讨Tfh细胞在ITP发病机制中的作用。选取2013年1月至10月在天津医科大学总医院血液科就诊的21例初治ITP患者、20例恢复期ITP患者及18名正常对照者,采用流式细胞术检测骨髓Tfh细胞数量、Tfh细胞功能相关分子CD40L、ICOS、IL-21的表达,采用RT-PCR技术检测BMMNC转录因子BCL-6 mRNA相对表达水平;并将各项指标与疾病严重程度进行相关性分析。结果表明,ITP初治组骨髓CD4+CXCR5+/CD4+细胞比例[(5.532±2.599)%]高于恢复期组[(4.064±2.026)%]和对照组[(4.048±1.413)%](P<0.05);ITP初治组骨髓CD4+CXCR5+ICOS+/CD4+CXCR5+细胞比例[(14.586±8.561)%]高于恢复期组[(12.884±10.161)%]和对照组[(7.487±5.176)%],初治组与对照组相比差异有统计学意义(P<0.05);ITP初治组和恢复期组骨髓CD4+CXCR5+CD40L+/CD4+CXCR5+细胞比例[(15.309±10.756)%]及[(18.242±12.243)%],高于对照组[(8.618±5.719)%](P<0.05);ITP初治组和恢复组骨髓CD4+CXCR5+IL-21+/CD4+CXCR5+细胞比例[(58.560±26.285)%]及[(57.035±30.936)%]高于对照组[(36.289±24.868)%](P<0.05);初治组、恢复组、对照组BCL-6 mRNA的表达水平分别为(1.407±0.264)、(1.149±0.217)和(0.846±0.157),差异均有统计学意义(P值均<0.05)。结论:Tfh细胞在ITP患者的骨髓中数量增加,功能分子表达增多,功能亢进,在ITP发病机制中可能有重要作用。This study was purposed to detect the quantity and function of bone marrow （BM） T follicular helper （Tfh） cells of patients with immune thrombocytopenia, and to explore the role of Tfh cells in the pathogenesis of ITP. Twenty-one newly diagnosed ITP patients, twenty ITP patients in recovery stage and eighteen normal controls were en rolled in this study. The percentages of Tfh cells, Tfh-related molecules ICOS, CD40L, IL-21 in BM were detected by flow cytometry （FCM）, and the mRNA expression of BCL-6 in BMMNC was determined by semiquantitive RT-PCR. Correlation of Tfh cell level with the disease severity of ITP patients was analysed. The results showed that the ratio of CIM＋CXCR5 ＋/CIM ＋ cells in newly diagnosed ITP patients [ （ 5. 532 ± 2.599 ） % ] was significantly higher than that in ITP patients with recovery stage [ （4.064 ± 2.026 ） % ] and controls [ （ 4. 048 ± 1. 413 ） % ] （ P 〈 0.05 ）. The ratio of CD4＋ CXCR5 ＋ ICOS ＋/CD4 ＋ CXCR5 ＋ cells in newly diagnosed ITP patients E （ 14.586 ± 8. 561 ） % ] was higher than that in recovery stage ITP patients [ （ 12.884±10. 161 ） % ] and controls [ （7. 487 ±5. 176） % ]. The differences betwees newly diagnosed ITP patients and controls were stafistlcally significant （ P 〈0.05） The ratio of CD4 ＋CXCR5 ＋CD40L ＋/CD4 ＋ CXCR5 ＋ cells in newly diagnosed ITP patients[ （15. 309 ±10. 756）% ] and in ITP patients with recovery stage E （ 18. 242 ± 12.243 ） % ] were significantly higher than that in controls [ （ 8.618 ±5.719 ） % ] （ P 〈 0.05 ）. The ratio of intracytoplasm CD4＋ CXCR5 ＋ IL-21 ＋/CD4 ＋ CXCR5 ＋ cells in newly diagnosed ITP patients （ 58. 560 ± 26. 285 ） % ] and in ITP patients with recovery stage ＋ （ 57.035 ± 30. 936 ） % ] were significantly higher than that in controls [（ 36.289 ± 24.868 ） % ] （ P 〈 0.05 ）. The relative expression levels of BCL-6 mRNA in BMMNC of three groups were （ 1. 407 ± 0. 264）, （ 1. 149± 0.217） and （ 0.

关 键 词：免疫性血小板减少症 滤泡辅助性T细胞 BCL-6 

分 类 号：R558.2[医药卫生—血液循环系统疾病]