IDO/TTS介导的色氨酸代谢途径在免疫性血小板减少症患者发病及治疗中的作用  

Role of IDO/TTS-mediated tryptophan metabolic pathway in the pathogenesis and treatment of patients with immune thrombocytopenia

作　　者：应伊丽 袁远[2] 

机构地区：[1]浙江省台州医院输血科,浙江临海317000 [2]浙江省台州医院检验科,浙江临海317000

出　　处：《中国现代医生》2017年第36期6-9,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2015KYB442)

摘　　要：目的探讨IDO/TTS介导的色氨酸代谢途径在免疫性血小板减少症患者的发病和治疗中的作用。方法选取2015年7月~2017年8月我院收治的36例免疫性血小板减少症患者和36例来我院体检的健康人为研究对象,分别为观察组和对照组,观察组给予地塞米松40 mg/d进行治疗,对照组不采取任何处理。通过液相-质谱分析仪检测血浆中犬尿氨酸(Kyn)和色氨酸(Trp)的浓度;通过流式细胞仪检测T淋巴细胞中IDO和TTS的表达。结果与对照组相比,治疗前免疫性血小板减少症患者血浆中Kyn、Trp、Kyn/Trp的表达量较高,IDO的表达量较低,而TTS的表达量则明显较高,差异有统计学意义(P<0.05);观察组经有效治疗后,患者血浆中Trp的浓度降低,而Kyn浓度及Kyn/Trp比值则明显升高,差异有统计学意义(P<0.05);患者IDO表达量明显上升,而TTS的表达量则明显下降,差异有统计学意义(P<0.05)。结论地塞米松对免疫性血小板减少症患者疗效显著,主要通过IDO/TTS介导的色氨酸代谢途径发挥作用,临床可以通过监测IDO、TTS的水平指导其治疗。Objective To investigate the role of IDO/TTS-mediated tryptophan metabolic pathway in the pathogenesis and treatment of patients with immune thrombocytopenia. Methods A total of 36 patients with immune thrombocytope- nia admitted in our hospital from July 2015 to August 2016 and 36 healthy volunteers who were in our hospital for physical examination were divided into observation group and control group. The observation group was given dexam- ethasone 40 mg/d. The control group was not given any treatment. Plasma concentrations of Kyn and Tryptophan were measured by liquid chromatography-mass spectrometry. The expression of IDO and TTS in T lymphocytes was detected by flow cytometry. Results Compared with that of the control group, the Kyn, Trp and Kyn/Trp plasma level in patients with pre-immune thrombocytopenia was higher, and the expression of IDO was lower, and the expression of TTS was significantly higher, and the difference was significant（P〈0.05）. After effective treatment, the concentration of Trp in the plasma of the observation group was decreased, while the Kyn concentration and Kyn/Trp ratio of the observation group was significantly increased, and the difference was statistically significant（P〈0.05）. The IDO expression level significantly increased, while the expression of TTS was significantly decreased, and the difference was statistically significant（P〈0.05）. Conclusion Dexamethasone has a significant effect on patients with immune thrombocytopenia. It plays a role mainly through the tryptophan metabolic pathway mediated by IDO/TTS. Dexamethasone can monitor the level of IDO and TTS in order to guide its treatment. Clinically, IDO and TTS levels can be monitored to guide the treatment.

关 键 词：IDO TTS 免疫性血小板减少症 发病 治疗 

分 类 号：R593.2[医药卫生—内科学]