免疫失耐受在原发免疫性血小板减少症中的作用机制  

Mechanism of immune tolerance breakdown in primary immune thrombocytopenia

作　　者：闫涵 陈涛 张牛霖 高明洁[2] 赵雨婷 杜福泉 李鹤然 刘汭沅 王照宇 王金环[2] YAN Han;CHEN Tao;ZHANG Niulin;GAO Mingjie;ZHAO Yuting;DU Fuquan;LI Heran;LIU Ruiyuan;WANG Zhaoyu;WANG Jinhuan(Graduate School of Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;Department of Hematology,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;College of Traditional Chinese Medicine,Beijing University of Traditional Chinese Medicine,Beijing 100105,China)

机构地区：[1]黑龙江中医药大学研究生学院,哈尔滨150040 [2]黑龙江中医药大学附属第一医院血液病科,哈尔滨150040 [3]北京中医药大学中医学院,北京100105

出　　处：《生命的化学》2024年第11期2100-2107,共8页Chemistry of Life

基　　金：国家自然科学基金项目(81673968);全国中医临床特色技术传承骨干人才项目[国中医药人教函(2019)36号];黑龙江省中医药学会青年中医药科技创新项目(ZHY19-029);黑龙江中医药大学创新人才基金项目(2018KCD04);黑龙江中医药大学科研基金项目(2019MS14)。

摘　　要：原发免疫性血小板减少症(immune thrombocytopenia,ITP)作为一种自身免疫性疾病,其核心机制为自身反应性T、B细胞攻击血小板和巨核细胞,导致血小板的生成减少和破坏增加。免疫失耐受指免疫耐受机制的失调导致机体无法有效清除自身反应性T、B细胞,导致免疫系统对自身抗原失去耐受性,攻击自身组织。ITP患者可能存在免疫失耐受导致机体无法有效清除自身反应性T、B细胞,最终导致免疫系统对自身抗原失去耐受性继而攻击血小板和巨核细胞,引发ITP。本文通过分析免疫耐受建立的生理学机制,从B细胞免疫耐受机制失调、T细胞免疫耐受机制失调两方面论述了免疫失耐受在ITP发病机制中的关键作用,以期为ITP的治疗提供新的靶点和研究方向。As an autoimmune disease,the core mechanism of primary immune thrombocytopenia(ITP)is that autoreactive T and B cells attack platelets and megakaryocytes,resulting in decreased production and increased destruction of platelets.Immune intolerance refers to the dysregulation of immune tolerance mechanism,which leads to the inability of the body to effectively clear self reactive T and B cells,resulting in the loss of tolerance of the immune system to self antigens and attacking its own tissues.ITP patients may have immune intolerance,which leads to the body’s inability to effectively clear self reactive T and B cells,and eventually leads to the loss of tolerance of the immune system to self antigens,which then attacks platelets and megakaryocytes,and finally triggers ITP.This paper discusses the key role of immune intolerance in the pathogenesis of ITP from two aspects:the dysregulation of B cell immune tolerance mechanism and the dysregulation of T cell immune tolerance mechanism,by analyzing the physiological mechanism of the establishment of immune tolerance,in order to provide new targets and research directions for the treatment of ITP.

关 键 词：原发免疫性血小板减少症 免疫失耐受 中枢耐受 外周耐受 发病机制 

分 类 号：R558.2[医药卫生—血液循环系统疾病]