IL-21在ITP中的表达及大剂量地塞米松对其调控的研究  

Effects of the Interleukin-21 Expression in Patients with Immune Thrombocytopenia and Its Regulation by High-Dose Dexamethasone

作　　者：张茜[1] 白海[1] 王美亮[2] 马慧[3] 张新玲[4] 王存邦[1] 潘耀柱[1] 蒽瑞[1] 吴涛[1] 徐淑芬[1] 

机构地区：[1]兰州军区兰州总医院血液科,甘肃兰州730050 [2]兰州军区兰州总医院医学实验科,甘肃兰州730050 [3]兰州军区兰州总医院信息科,甘肃兰州730050 [4]兰州军区兰州总医院感染控制科,甘肃兰州730050

出　　处：《中国实验血液学杂志》2015年第2期465-470,共6页Journal of Experimental Hematology

基　　金：甘肃省自然科学基金(1010RJZA054)

摘　　要：目的:探究免疫性血小板减少症(immunologic thrombocytopenia,ITP)与IL-21表达异常的相关性,同时探究大剂量地塞米松(high-dose dexamethasone,HD-DXM)冲击治疗ITP的疗效是否与IL-21有关。方法:抽取26例初诊ITP患者及24例健康人的外周血10 ml,密度梯度离心法获得血清及单个核细胞,分别采用流式细胞术和实时荧光定量PCR法检测单个核细胞IL-21的表达,采用酶联免疫吸附实验(ELISA)检测ITP治疗前后及正常对照者血浆中IL-21,IFN-γ和IL-4的水平。结果:流式细胞术测定发现,ITP患者单个核细胞表面分子IL-21表达明显高于健康对照(13.07%vs 8.2%);ITP患者IL-21 mRNA(9.524±0.97)与健康对照组(3.701±0.60)存在显著统计学差异,经HD-DEX治疗后IL-21 mRNA的比率值(5.87±1.21)较治疗前显著降低(P<0.01);ITP患者血清中IL-21和IFN-γ水平与健康对照组和HD-DEX治疗组相比均具有显著的统计学差异(P<0.01);而IL-4在治疗后含量却上调,与治疗前相比有统计学意义。结论:IL-21的表达异常参与了ITP发病过程,地塞米松对ITP的疗效与下调IL-21表达有关。Objectlve：To investigate the correlation of immunologic thrombocytopenia（ITP） pathogenesis with the abnormal expression of IL-21, and to explore the association of high-dose dexamethasone （HD-DEX） treatment with the IL-21 expression. Methods： 26 newly diagnosed ITP patients and 24 healthy controls were enrolled in this study. The mononuclear cells and serum were obtain from density gradient centrifugation in the newly diagnosed ITP patients before HD-DXM treatment, and the samples of healthy controls were also used for assays. The protein and mRNA expression of IL-21 on peripheral blood mononuclear cells （MNC） were determined by flow cytometry and real-time reversetranscription polymerase chain reaction. Plasma levels of IL-21, IFN-Y and IL-4 were determined by enzyme-linked immunoabsorbent assay （ELISA）. Results： IL-21 expression on mononuclear cells was significantly higher in ITP patients （ 13.07% ） than that in normal controls （8.2%）, the ratio of IL-21/GAPDH mRNA expression on MNC was significantly higher in ITP patients （9.524±0.97） than that in normal controls （3. 701±0.60, P 〈0.01 ）. After HD- DXM therapy, the ratio of IL-21/GAPDH mRNA decreased significantly （ 5.87 ±1.21 ） as compared with the level before treatment. Significantly high levels of serum IL-21, IFN-Y and lower IL-4 were found in ITP patients, as compared with healthy controls. Serum IL-21 and IFN-Y levels in ITP patients decreased significantly after HD-DXM administration （P 〈0. 01）, while post-treatment levels of IL-4 were increased significantly, compared with the levels before treatment （P 〈0. 01 ）. Conclusion：Therapeutic effect of DXM on ITP associates with down-regalation of IL-21 exoression. The increased exoression of IL-21 involves in the nathoenesis of ITP.

关 键 词：免疫性血小板减少症 地塞米松 白介素-21 

分 类 号：R558.2[医药卫生—血液循环系统疾病]