慢性特发性血小板减少性紫癜淋巴细胞和血小板凋亡蛋白的表达  

The expression of Fas protein and Fas-L protein in the lymphocytes and platelets from patients with idiopathic thrombocytopenic purpura

作　　者：高清平[1] 黄望香[2] 李秀珍[1] 

机构地区：[1]武汉大学人民医院血液科,武汉430060 [2]深圳市龙岗中心医院血液科

出　　处：《临床血液学杂志》2001年第3期104-106,共3页Journal of Clinical Hematology

基　　金：湖北省教育委员会基金资助项目

摘　　要：目的 :从细胞凋亡的角度探讨慢性特发性血小板减少性紫癜 (ITP)的发病机制。方法 :用流式细胞仪检测 30例 ITP患者治疗前后 T(CD3+ )、B(CD1 9+ )淋巴细胞及血小板 Fas蛋白和 Fas- L 蛋白的表达。结果 :治疗前 T淋巴细胞的 Fas蛋白表达明显低于正常者 ,Fas- L 蛋白表达明显高于正常对照者 ,B淋巴细胞的 Fas和Fas- L蛋白表达与正常对照者相比差异无统计学意义。血小板恢复正常的患者 T淋巴细胞的 Fas蛋白表达上调和 Fas- L蛋白表达下调 ,与治疗前相比差异有统计学意义 ,与正常对照者相比差异无统计学意义。治疗前的血小板 Fas和 Fas- L蛋白的表达均显著高于正常对照者。经治疗血小板恢复正常的患者血小板 Fas和 Fas- L蛋白表达均显著下调 ,与治疗前相比差异有显著性意义。结论 :未治疗的 ITP患者体内大量表达 Fas- L蛋白的 T淋巴细胞与高表达的 Fas蛋白的血小板结合后 ,T淋巴细胞可发挥细胞毒作用 ,杀伤血小板 ;另外 ,血小板同时高表达Fas和 Fas- L蛋白 ,血小板通过 cis途径凋亡而减少。经肾上腺皮质激素等治疗可通过下调血小板 Fas和 Fas- L蛋白的表达而阻止血小板 cis凋亡 ,下调 T淋巴细胞 Fas- L蛋白的表达 ,减少 T淋巴细胞对血小板的细胞毒性作用。Objective:To investigate the role of apoptosis in the pathogenesis of idiopathic thrombocytopenic purpura(ITP).Methods:Flow cytometry was used to the expression of Fas protein and Fas L protein in CD 3 + (T) and CD 19 +(B) lymphocytes and platelets of 30 ITP patients and 20 normal controls.Results:Fas protein on T lymphocytes was lowly expressed,and Fas L protein was highly expressed in untreated ITP patients,The expression of Fas and Fas L protein on B lymphocytes are normal expression. The expression of Fas was increased on T lymphocytes and that of Fal L was decreased in treated patients whose platelets were normal.The expression of Fas and Fas L protein in platelets are increased inuntreated ITP patients.The expression of Fas and Fas L protein in platelets are decreased in ITP patients whose platelets recovered to normal after therapy.Conclusion:In untreated ITP patients,T lymphocytes which overexpressed Fas L protein combined with platelets that overexpressed Fas protein may produce cytotoxicity against platelets. Furthermore,overexpressed Fas and Fas L protein simultaneously induced apoptosis of platelets.The therapy of glucocorticoid downregulated the expression of Fas and Fas L protein to inhibit Fas induced apoptosis of platelets; and downregulated the expression of Fas L protein on T lymphocytes to decrease the cytotoxicity of T lymphocytes against platelets.

关 键 词：血小板减少性紫癜 血小板 FAS蛋白 FAS-L蛋白 

分 类 号：R554.6[医药卫生—血液循环系统疾病]