原发免疫性血小板减少症(ITP)患者外周IL-37的水平变化及其与T亚群、NK细胞的相关性研究  

Relationship of Peripheral Blood IL-37 Expression with T Lymphocytes Subsets and NK Cells in Patients with Primary Immune Thrombocytopenia

作　　者：陈珍 瞿文[1] 王化泉[1] 邢莉民[1] 吴玉红[1] 刘召云[1] 张洋[1] 刘惠[1] 董喜凤[1] 陶景莲[1] 邵宗鸿[1] CHEN Zhen;QU Wen;WANG Hua-Quan;XING Li-Min;WU Yu-Hong;LIU Zhao-Yun;ZHANG Yang;LIU Hui;DONG Xi-Feng;TAO Jing-Lian;SHAO Zong-Hong(Department of Hematology,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院血液科

出　　处：《中国实验血液学杂志》2019年第4期1201-1207,共7页Journal of Experimental Hematology

摘　　要：目的:分析ITP患者外周血IL-37表达水平变化及其与T亚群、NK细胞数的相关性,探讨其参与疾病发病的可能机制。方法:选取初诊组ITP患者45例,完全缓解组ITP患者32例及正常对照组22例。采用酶联免疫吸附试验法(ELISA)测定3组外周血血清中IL-37水平,应用实时荧光定量聚合酶链式反应(PCR)测定3组外周单个核细胞内IL-37、IL-18、IL-17mRNA相对表达水平,采用流式细胞术(FCM)检测3组IL-18Rα^+CD4^+T细胞比例,2组Tim-3+NK细胞比例。结果:初诊组ITP患者血清IL-37水平高于缓解组患者及正常对照组(P<0.01);初诊组IL-37mRNA表达水平高于缓解组及正常对照组(P<0.01),缓解组IL-37mRNA表达水平高于正常对照组(P<0.05)。初诊组IL-18、IL-17mRNA表达水平均明显高于缓解组及正常对照组(P<0.01)。流式细胞术检测表明,初诊组的IL-18Rα^+CD4^+T细胞比例比缓解组和对照组增高,且差异具有统计学意义。初诊组的Tim-3+NK细胞比例比对照组低,且差异具有统计学意义(P<0.01);在ITP患者中,血清IL-37水平和IL-18Rα^+CD4^+T细胞比例均与血小板数量呈负相关(r=-0.58;r=-0.48),与CD4^+T细胞数、NK细胞数呈负相关(r=-0.29;r=-0.28),与CD8+T细胞量呈正相关(r=0.329)。结论:IL-37及其受体可能在ITP患者的CD4+T细胞和NK细胞发挥免疫调节作用,IL-37可以成为免疫性血小板患者的治疗靶标。Objective:To study the correlation of IL-37 with T lymphocytes subsets and NK cells in ITP patients, and to explore its possible mechanisms involved in the pathogenesis of ITP.Methods:Forty-five patients with newly diagnosed ITP( newly diagnosed group),32 patients of complete remission ( remission group) and 22 healthy persons ( control group) were selected.The serum level of IL-37 in 3 groups was determined by enzyme linked immunosorbent assay ( ELISA).The mRNA expression of IL-37,IL-17 and IL-18 in peripheral blood mononuclear cells( PBMNC) in 3 groups was measured by real-time fluorescence quantitative polymerase chain reaction ( PCR).The number of IL-18Rα^+ CD4^+ T cells and Tim-3^+ NK cells in the peripheral blood in 3 groups was detected by flow cytometry ( FCM ). Results:The serum level of IL-37 in the peripheral blood of ITP patients in the newly diagnosed group was significantly higher than that in the control group and the remission group( P < 0.01).The expression level of IL-37 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group( P < 0.05). The expression level of IL-17 and IL-18 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group( P < 0.01);the expression of IL-18Rα in CD4^+ T cells in newly diagnosed group was significantly higher than that in both the control and the remission group( P < 0.01).The expression of Tim-3 in NK cells in ITP patients was significantly lower than that in the control group ( P < 0.01).In ITP patients,the serum IL-37 level and IL-18Rα^+ CD4^+ T cells ratio both negatively correlated with Plt count ( r =- 0.58,r =- 0.48) moreo-ver the serum IL-37 level also negatively correlated with amount of CD4^+ T cells and NK cells ( r =- 0.29,r =- 0. 28),but positively correlated with amount of CD8^+ T cells ( r = 0.329).Conclusion:The IL-37 and its receptors may play an immunoregulatory role in CD4^+ T cells and NK cells,the IL-37 may be a therapeut

关 键 词：原发免疫性血小板减少症 IL-37 IL-18 IL-18Rα NK细胞 

分 类 号：R558.2[医药卫生—血液循环系统疾病]