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作 者:全日城[1] 王子卿 许勇钢[1] 杨晓红[1] 胡晓梅[1] 麻柔[1] 张姗姗[1] QUAN Richeng;WANG Ziqing;XU Yonggang;YANG Xiaohong;HU Xiaomei;MA Rou;ZHANG Shanshan(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)
出 处:《中国中医基础医学杂志》2022年第10期1653-1657,共5页JOURNAL OF BASIC CHINESE MEDICINE
基 金:国家重点基础研究发展计划(973计划)项目(2015CB554403)-气不摄血证免疫性血小板减少症的临床研究。
摘 要:目的探索益气温阳汤治疗慢性免疫性血小板减少症(chronic immune thrombocytopenia,CITP)的免疫调控机制及转录因子GATA结合蛋白(GATA binding protein,GATA)-3通路对血小板计数的预测价值。方法纳入28例CITP患者为治疗组,20名健康志愿者为健康对照组,治疗组给予益气温阳汤治疗,健康对照组不给予干预,4个月后用流式细胞术检测治疗前后外周血T、B淋巴细胞亚群及辅助性T细胞(helper T cell,Th)1、Th2水平,荧光定量PCR检测T-bet、GATA-3、Foxp3 mRNA表达水平,Logistic回归分析法对血小板相关预测因素进行分析。结果益气温阳汤治疗CITP总有效率42.86%,与治疗前比较,治疗组治疗后CITP患者CD3+总T细胞、细胞毒性T淋巴细胞(cytotoxic T lymphocyte,CTL)、自然杀伤T细胞(natural killer T cell,NKT)、GATA-3 mRNA表达水平显著降低,血小板、CD5+B淋巴细胞比值、调节性T细胞(regulatory T cell,Treg)、Th2细胞水平升高(P<0.05);治疗组治疗后Foxp3 mRNA表达水平显著低于健康对照组(P<0.05)。Logistic回归分析显示,治疗后GATA-3水平与血小板呈负相关,方程式:血小板=90.299-64.086×(GATA-3)。结论益气温阳汤通过调节CITP患者T、B淋巴细胞亚群水平,起到免疫调节和免疫耐受作用,并可以通过调控GATA-3和Foxp3 mRNA表达提升血小板计数,GATA-3 mRNA的表达水平可能对CITP患者血小板计数有预测价值。Objective:To explore the immune regulation mechanism of Yiqing Wenyang Decoction in the treatment of chronic immune thrombocytopenia(CITP)and the effect of the transcription factor GATA-3 pathway on PLT forecast value.Methods:Twenty eight CITP patients were included as the treatment group and 20 healthy volunteers as the healthy control group.The treatment group was treated with Yiqi Wenyang decoction,and the healthy control group was not intervened for 4 months.The levels of T,B lymphocyte subsets and Th1 and Th2 in peripheral blood before and after treatment were detected by flow cytometry,and the mRNA expressions of T-bet,GATA-3 and Foxp3 were detected by RT-qPCR,logistic regression analysis was used to analyze the related predictive factors of PLT.Results:The total effective rate of Yiqi Wenyang decoction in the treatment of CITP was 42.86%.In the treatment group,compared with before treatment,CD3+total T cells,cytotoxic T lymphocyte(CTL)cells,natural killer T cells(NKT),GATA-3 mRNA levels were significantly reduced after treatment,PLT and the CD5+B lymphocyte ratio,Treg,and Th2 cell levels increased(P<0.05).Compared with the healthy control group,Foxp3 mRNA level was significantly reduced after treatment(P<0.05).Logistic regression analysis showed that GATA-3 level was negatively correlated with PLT after treatment,and the equation PLT=90.299-64.086×(GATA-3).Conclusion:Yiqi Wenyang decoction plays the role of immune regulation and immune tolerance by regulating the level of T and B lymphocyte subsets in patients with CITP,and can increase PLT count by regulating the expression of GATA-3 and Foxp3 mRNA.The expression of GATA-3 mRNA may have predictive value for PLT count in patients with CITP.
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