TIGIT、CD226、CD96和CD155在血小板糖蛋白自身抗体阳性的原发性免疫性血小板减少症的表达及临床意义  

Expression and clinical significance of TIGIT,CD226,CD96,and CD155 in platelet glycoprotein autoantibody-positive primary immune thrombocytopenia

作　　者：骆婷婷 张瑞[1] 王秀娟[1] 王璐[1] 陈双[1] LUO Tingting;ZHANG Rui;WANG Xiujuan;WANG Lu;CHEN Shuang(Laboratory of Hematology Center,the First Affiliated Hospital of Xinjiang Medical University,Hematology Institute of Xinjiang Uygur Autonomous Region,Urumqi,830054,China)

机构地区：[1]新疆医科大学第一附属医院血液病中心实验室,新疆维吾尔自治区血液病研究所,乌鲁木齐830054

出　　处：《临床血液学杂志》2024年第3期183-189,195,共8页Journal of Clinical Hematology

基　　金：新疆维吾尔自治区自然科学基金青年项目(No:2022D01C754)。

摘　　要：目的:探讨TIGIT、CD226、CD96和CD155在血小板糖蛋白自身抗体(platelet glycoprotein autoantibody,GPs)阳性的原发性免疫性血小板减少症(immune thrombocytopenia,ITP)患者外周血CD8^(+)T细胞和树突状细胞(dendritic cell,DC)膜表面的表达,并分析其临床意义。方法:选取41例GPs阳性的ITP患者和20例健康对照者,采用流式细胞术检测CD8^(+)T细胞表面TIGIT、CD226和CD96表达比例,并检测ITP患者外周血DC细胞的亚群变化及浆细胞样DC(plasma DC,pDC)上CD155的表达比例。结果:GPs阳性ITP组患者的pDC和CD155^(+)pDC比例均明显高于对照组,且GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)组均明显高于GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)组(P<0.05,F=40.83;P<0.01,F=59.50)。GPs阳性ITP组患者的TIGIT+CD8^(+)T细胞比例明显低于对照组,且GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)组明显低于GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)组(P<0.05,F=36.41),但CD226^(+)CD8^(+)T细胞与CD96^(+)CD8^(+)T细胞比例均明显高于对照组,且GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)组均明显高于GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)组(P<0.05,F=45.01;P<0.01,F=41.66)。GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)组与GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)组的CD155^(+)pDC与TIGIT+CD8^(+)T细胞比例呈负相关(P<0.01,r=-0.54;P<0.01,r=-0.76),与CD226^(+)CD8^(+)T细胞和CD96^(+)CD8^(+)T细胞比例呈正相关(P<0.05,r=0.61;P<0.05,r=0.51;P<0.01,r=0.79;P<0.01,r=0.73)。结论:TIGIT、CD226、CD96与CD155表达异常,导致GPs阳性的ITP的免疫失耐受,可能参与了疾病发生。Objective: To investigate the expression of TIGIT,CD226,CD96 and CD155 on CD8^(+)T cells and dendritic cells(DC)in the peripheral blood of patients with platelet glycoprotein autoantibody(GPs)-positive primary immune thrombocytopenia(ITP)and to analyze their clinical significance.Methods: Forty-one GP-positive ITP patients and 20 healthy individuals were selected.The flow cytometry was used to detect the percentage of TIGIT,CD226,and CD96 expression on CD8^(+)T cells and the changes in DC cell subsets and the percentage of CD155 expression on plasma DC(pDC)were analyzed.Results:The percentage of pDC and CD155^(+)pDC in the GPs-positive ITP group were significantly higher than those in the healthy control group,and they were significantly higher in the GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)group than those in the GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)group(P<0.05,F=40.83;P<0.01,F=59.50).On the other hand,the percentage of TIGIT+CD8^(+)T cells in the GPs-positive ITP group was significantly lower than that in the healthy control group,and it was significantly lower in the GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)group than that in the GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)group(P<0.05,F=36.41).However,the percentages of CD226^(+)CD8^(+)T cells and CD96^(+)CD8^(+)T cells were significantly higher than those in the control group,and they were significantly higher in the GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)group than those in the GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)group(P<0.05,F=45.01;P<0.01,F=41.66).The percentages of CD155^(+)pDC in the GPⅠb/Ⅸ^(-)/Ⅱb/Ⅲa^(+)group and GPⅠb/Ⅸ^(+)/Ⅱb/Ⅲa^(+/-)group were negatively correlated with TIGIT+CD8^(+)T cells(P<0.01,r=-0.54;P<0.01,r=-0.76),while it positively correlated with the percentages of CD226^(+)CD8^(+)T cells and CD96^(+)CD8^(+)T cells(P<0.05,r=0.61;P<0.05,r=0.51;P<0.01,r=0.79;P<0.01,r=0.73).Conclusion: The abnormal expression of TIGIT,CD226,CD96,and CD155 contributes to immune intolerance in GPs-positive ITP,which may be involved in the pathogenesis of the disease.

关 键 词：免疫性血小板减少症 抑制性分子 CD226 CD96 

分 类 号：R558.2[医药卫生—血液循环系统疾病]