IL-21在间充质干细胞治疗复发难治免疫性血小板减少症中的变化及意义  

Changes and significance of interleukin-21 in patients with relapsed and refractory immune thrombocytopenia treated with mesenchymal stem cells

作　　者：林通 刘艳 吴涛 张茜 LIN Tong;LIU Yan;WU Tao;ZHANG Qian(The 940th Hospital of Joint Logistic Support Force of PLA,Department of Medical Service,Lanzhou 730050,China;The 940th Hospital of Joint Logistic Support Force of PLA,Department of Hematology,Lanzhou 730050,China)

机构地区：[1]解放军联勤保障部队第940医院卫勤部,甘肃兰州730050 [2]解放军联勤保障部队第940医院血液科,甘肃兰州730050

出　　处：《西北国防医学杂志》2020年第6期356-360,共5页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省自然科学基金资助项目(1010RJZA054,145RJZA212)。

摘　　要：目的:探讨应用人脐带间充质干细胞(human umbilical cord mesenchymal stem cells,hUC-MSCs)治疗复发难治免疫性血小板减少症(immunologic thrombocytopenia,ITP)后白介素-21(interleukin-21,IL-21)的变化及意义,进一步了解hUC-MSCs的免疫调节机制。方法:选择我院复发难治ITP患者15例为研究组,体外培养hUC-MSCs后,分别以终浓度为1×10^7个/50 ml进行静脉输注;另选健康体检者16例为对照组。分别于治疗前后采用酶联免疫吸附试验法检测研究组外周血IL-21水平,并评价安全性及有效性。结果:研究组治疗前血清IL-21水平高于对照组,经hUC-MSCs治疗后显著降低,差异有统计学意义(P<0.01)。研究组第1次输注细胞后2例出现低热,经对症处理后恢复正常,输注前后检测肝功、肾功、尿常规无显著变化。治疗后11例患者血小板计数不同程度上升,治疗有效率为73.33%(11/15)。结论:hUC-MSCs治疗复发难治ITP安全性较好,可减轻出血症状、提高血小板数量、改善患者的生活质量,这可能与调控IL-21有关。Objective:To explore the changes and significance of interleukin-21(IL-21)after the application of human umbilical cord mesenchymal stem cells(hUC-MSCs)in the treatment of patients with relapsed and refractory immune thrombocytopenia(ITP),and to further understand the immunoregulatory mechanism of hUC-MSCs.Methods:Fifteen patients with refractory recurrent ITP in our hospital were selected as research group,and were given intravenous infusion a final concentration of 1×10^7/50 ml after vitro culture of hUC-MSCS.Another 16 healthy subjects were selected as the control group.The levels of IL-21 in peripheral blood were detected by enzyme-linked immunosorbent assay before and after treatment,and the safety and effectiveness were evaluated.Results:Serum IL-21 levels in research group were higher than that in control group,and decreased after treatment with hUC-MSCs.The difference was statistically significant(P<0.01).Fever occurred in 2 cases after the first infusion of cells,and return to normal after symptomatic treatment,and liver,kidney function,and routine urine tests showed no significant changes.11 patients′platelet counts rose to varying degrees in research group after treament,with effective rate was 73.33%(11/15).Conclusion:hUC-MSCs has a good safety in the treatment of patients with relapsed and refractory ITP,which can reduce hemorrhage symptoms,increase the number of platelets,and improve the quality of life of patients.The treatment of ITP through immunomodulation may be related to the regulation of IL-21.

关 键 词：免疫性血小板减少症 人脐带间充质干细胞 免疫调节 白介素-21 

分 类 号：R558[医药卫生—血液循环系统疾病]