泼尼松对免疫性血小板减少性紫癜患者T细胞和NK细胞凋亡信号通路的影响  

Effect of prednisone on apoptosis signal pathways of T and NK cells in patients with ITP

作　　者：周国忠[1] 钟永根[1] 孙荷[1] 余德豹 

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)临床检验中心,浙江绍兴312000

出　　处：《中华全科医学》2016年第2期273-274,297,共3页Chinese Journal of General Practice

基　　金：浙江省绍兴市科技计划项目(2012B70051)

摘　　要：目的从泼尼松对免疫性血小板减少性紫癜(ITP)患者症状缓解作用的角度,探讨泼尼松对外周血T淋巴细胞和NK淋巴细胞凋亡信号通路的作用。方法 31例初发免疫性血小板减少性紫癜患者经泼尼松治疗6个月,用流式细胞术检测患者治疗前与治疗后外周血T淋巴细胞和NK淋巴细胞上分子(CD95L、Caspase-3和Caspase-8)的表达水平。结果与治疗前相比,泼尼松治疗后的ITP患者中CD3、NK、CD3^+CD95L^+、CD3^+Caspase-8~^+水平有显著性升高(P<0.05),NK^+Caspase-8^+水平呈显著性下降(P<0.05)。NK^+Caspase-8^+和NK^+Caspase-3^+存在正相关(P<0.01),NK^+Caspase-3^+与NK^+CD95L^+存在正相关(P<0.01),表明NK细胞上Caspase和Fas-Fas L与细胞凋亡途径相关。CD3^+Caspase-8^+和NK^+Caspase-8^+存在正相关(P<0.01),表明T淋巴细胞启动凋亡程序时与NK细胞相关。结论泼尼松通过调节T淋巴细胞和NK淋巴细胞介导的CD95L、Caspase-3和Caspase-8凋亡信号通路使ITP患者的症状缓解,为临床治疗提供参考作用。Objective To investigate the effect of prednisone on apoptosis signal pathways of T lymphocyte and NK lymphocyte in peripheral, from the point that prednisone could alleviate the symptom of patients with Idiopathic thrombocytopenic purpura（ITP）. Methods Thirty-one incipient ITP patients were treated by prednisone for 6 months. The flow cytometry was adapted to detect molecules（ CD95L, Caspase-3, and Caspase-8 ） on T cells and NK cells lymphocyte before and after treatment. Results Compared with the levels before treatment,the expression of CD3 ,NK,CD3 ^＋ CD95L^＋ ,and CD3 ^＋ Caspase-8 ^＋ were significantly increased（ P 〈 0.05 ） and NK^ ＋ Caspase-8 ^＋ was significantly decreased（ P 〈 0.05 ）. It was positive correlation both NK ^＋ Caspase-8 ^＋ and NK ＋ Caspase-3 ^＋ （ P 〈 0.01 ） , and NK ^＋ Caspase-3 ＋ was positively correlated with NK ^＋ CD 95L ^＋ （P 〈 0.01 ）, it showed that Caspase and Fas-FasL were associated with apoptosis pathway on NK cells. It was positive correlation both CD3 ^＋ Caspase-8 ^＋ and NK ^＋ Caspase-8 ＋ （ P 〈 0.01 ）, it showed that T lymphocyte start with NK ceils apoptosis process. Conclusion Prednisone may regulate apoptosis signal pathway （CD95L, Caspase- 3, and Caspase-8） mediated by T and NK lymphocyte to alleviate the symptom of patients, which can be used as a reference for clinical treatment.

关 键 词：免疫性血小板减少性紫癜 CD95L Caspase-3 CASPASE-8 

分 类 号：R593.2[医药卫生—内科学] R329.28[医药卫生—临床医学]