摘要
目的研究免疫性血小板减少症(ITP)患者治疗前后外周血中调节性B细胞(Breg细胞)、调节性T细胞(Treg细胞)的表达及与白细胞介素(IL)-10、肿瘤坏死因子α(TNF-α)的相关性,探讨以上指标在ITP患者发病中的免疫调节机制。方法选取2017年3月至2019年12月该院血液病科收治的初诊患有ITP的住院患者35例,治疗前PLT<30×109/L(ITP治疗前组),治疗后PLT>50×109/L(ITP治疗后组);选取同期该院体检中心体检健康者40例作为健康对照组。使用流式细胞术检测ITP患者治疗前后及健康对照组外周血Breg和Treg细胞的表达,采取流式Aimplex法检测外周血IL-10、TNF-α水平。分析ITP患者治疗前后Breg、Treg表达与IL-10、TNF-α水平的相关性。结果与健康对照组比较,Breg细胞占CD19+细胞的百分比及Treg细胞占CD4+细胞的百分比在ITP治疗前组均显著降低,差异有统计学意义(P<0.01);ITP治疗后组较健康对照组仍降低,差异有统计学意义(P<0.05);但ITP治疗后组较ITP治疗前组显著升高,差异有统计学意义(P<0.01)。Breg细胞占CD19+细胞百分比与Treg细胞占CD4+细胞百分比呈正相关(r=0.6917,P<0.01),Breg细胞占CD19+细胞百分比与IL-10水平呈正相关(r=0.7632,P<0.01)。与健康对照组比较,ITP治疗前组外周血IL-10水平显著降低;与ITP治疗前组比较,ITP治疗后组外周血IL-10水平显著升高,差异均有统计学意义(P<0.01)。此外,Breg细胞占CD19+细胞百分比与TNF-α水平呈负相关(r=-0.6471,P<0.01)。与健康对照组比较,ITP治疗前组外周血TNF-α水平显著升高;与ITP治疗前组比较,ITP治疗后组外周血TNF-α水平显著降低,差异均有统计学意义(P<0.01)。结论外周血Breg细胞可通过分泌IL-10对Treg细胞的表达进行调节,Breg、Treg细胞能够通过分泌细胞因子影响ITP的免疫调节与疾病进展。
Objective To study the expression of regulatory B cells(Breg cells)and regulatory T cells(Treg cells)in peripheral blood and their correlation with interleukin 10(IL-10)and tumor necrosis factor alpha(TNF-α)in patients with immune thrombocytopenia(ITP)before and after treatment,and to explore the immune regulation mechanism of these indexes in the pathogenesis of ITP.Methods A total of 35 patients with ITP From March 2017 to December 2019 were selected from the Hematology Department of the hospital.PLT<30×109/L before treatment(ITP before treatment group)and PLT>50×109/L after treatment(ITP treatment group),40 patients with physical examination in the hospital physical examination center were selected as the healthy control group.Flow cytometry was used to detect the expression ratio of Breg and Treg cells in peripheral blood of ITP patients before and after treatment and healthy control group.Flow cytometry was used to detect the levels of IL-10 and TNF-αin peripheral blood.The correlation between the proportion of Breg,Treg and the levels of IL-10,TNF-αin ITP patients before and after treatment was analyzed.Results Compared with the healthy control group,Breg cells in CD19+cells and the percentages of Treg cells in CD4+T cells in ITP before treatment group were significantly lower(P<0.01);the percentages in ITP treatment group were still lower than the healthy control group(P<0.05);but the percentages of ITP treatment group were significantly higher than the ITP before treatment group(P<0.01).There was a positive correlation between the percentages of Breg cells in CD19+cells and the percentages of Treg cells in CD4+cells(r=0.6917,P<0.01),and between the percentages of Breg cells in CD19+cells and IL-10(r=0.7632,P<0.01).The level of IL-10 in peripheral blood of ITP before treatment group was significantly lower than that of healthy control group,the level of IL-10 in ITP treatment group increased significantly(P<0.01).In addition,the percentages of Breg cells in CD19+cells was negatively correlated with TN
作者
郝立君
许腾
李智伟
杨舒婷
刘红春
HAO Lijun;XU Teng;LI Zhiwei;YANG Shuting;LIU Hongchun(Clinical Examination Center,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)
出处
《国际检验医学杂志》
CAS
2021年第9期1074-1078,共5页
International Journal of Laboratory Medicine
基金
新疆维吾尔自治区自然科学基金项目(2021D01C152)
新疆维吾尔自治区人民医院科技引进创新项目(20170306)
国家自然科学基金项目(81860375)。
