初发过敏性紫癜和紫癜性肾炎患儿滤泡辅助性T细胞变化初探  

Changs of T Follicular Helper Cell in Children Primary Henoch-Schnlein Purpura and Henoch-Schnlein Purpura Nephrits

作　　者：贾实磊[1] 杨军[1] 马颐姣[1] 李薇玢[1] 李成荣[1] 周厚福[1] 

机构地区：[1]广东省深圳市儿童医院,广东深圳518026

出　　处：《儿科药学杂志》2018年第1期1-4,共4页Journal of Pediatric Pharmacy

基　　金：深圳市医学科技项目基金资助;编号201607048

摘　　要：目的:探讨滤泡辅助性T(Tfh)细胞在儿童初发过敏性紫癜(HSP)、紫癜性肾炎(HSPN)中的变化及其可能机制。方法:选择初发HSP患儿45例,采用流式细胞术检测外周血CD4+CXCR5+ICOS+T细胞(Tfh细胞)的比例,荧光实时定量聚合酶链反应(RT-PCR)检测转录因子Bcl-6、Blimp-1的mRNA表达,酶联免疫吸附试验(ELISA)法检测IL-21、IL-4血浆浓度。密切随访HSP患儿6个月。6个月时,根据是否有肾脏受累分为HSPN组19例和HSP组26例。另选取20例健康体检儿童为对照组。结果:(1)HSP组患儿Tfh细胞比例高于正常对照组(3.75%±1.32%vs 2.01%±0.72%,P<0.05);HSPN组患儿Tfh细胞比例高于HSP组(5.86%±1.94%vs 3.75%±1.32%,P<0.05);(2)Tfh细胞正性转录调节因子Bcl-6 mRNA表达HSPN组高于HSP组(P<0.05),均高于正常对照组(P<0.05);负性调节因子Blimp-1 mRNA表达HSPN组低于HSP组(P<0.05),均低于正常对照组(P<0.05);(3)Tfh细胞相关细胞因子IL-21血浆浓度HSPN组高于HSP组(P<0.05),均较正常对照组增高(P<0.05)。抑制Blimp-1表达的IL-4血浆浓度HSPN组和HSP组均高于正常对照组(P<0.05),但HSPN组和HSP组比较差异无统计学意义(P>0.05)。结论:Tfh细胞过度活化可能参与HSP免疫发病机制,Tfh细胞高表达可能是导致HSP患儿肾脏损害的原因之一。Objective： To explore the changes and mechanism of T follicular helper（ Tfh） cells in children with primary HenochSchnlein purpura（ HSP） and Henoch-Schnlein purpura nephritis（ HSPN）. Methods： Forty-five children with HSP were enrolled in this study. The proportion of CD4＋CXCR5＋ICOS＋T cells in peripheral blood was analyzed by flow cytometry. Real-time PCR was performed to detect the level of Tfh cells transcriptional factor（ Bcl-6） and its inhibitor（ Blimp-1）. The plasma concentrations of IL-21 and IL-4 were determined by ELISA. HSP children were followed up for 6 months,depending on whether the kidney was involved,they were divided into HSP group（ 26 cases） and HSPN group（ 19cases）. Twenty health children were selected as the control group.Results：（ 1） The proportion of Tfh cells in HSP group was significantly higher than control group（ 3. 75% ±1. 32% vs 2. 01% ±0. 72%,P〈0. 05）. The proportion of Tfh cells in HSPN group was significantly higher than that of HSP group（ 5. 86% ± 1. 94% vs 3. 75% ±1. 32%,P〈0. 05）.（ 2） The mRNA expression of Bcl-6 was significantly elevated in HSPN group,which was significantly higher than that of HSP group（ P〈0. 05）,and both of them were higher than that of control group（ P〈0. 05）. Simultaneously,the mRNA expression of Blimp-1 was found to be down-regulated in HSPN group,which was significantly lower than that of HSP group（ P〈0. 05）,and both of them were lower than control group（ P〈0. 05）.（ 3） The plasma IL-21 concentration in HSPN group was significantly higher than that of HSP group（ P〈0. 05）,and both of them were significantly increased in comparison with control group（ P〈0. 05）. There was no significantly difference of the plasma IL-4 concentration between HSP group and HSPN group（ P〈0. 05）,but both of them were higher than that of control group（ P〈0. 05）. Conclusion： The over-activation of Tfh cells may be correlated with immune pathogenesis in HSP. Aberra

关 键 词：滤泡辅助性T细胞 BCL-6 BLIMP-1 过敏性紫癜 肾炎 

分 类 号：R725.9[医药卫生—儿科]