【摘要】 目的 探讨原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)中TRAIL的表达及其在发病机制中的作用。方法 使用Ficoll密度梯度离心法,收集28例ITP患者和30例健康对照的外周血单个核细胞(PBMC)。采用实时荧光定量PCR检测TRAIL基因的表达,采用ELISA方法检测血清中细胞因子TNF-α,IFN-γ,IL-4和IL-10的量,并分析TRAIL与患者TNF-α,INF-γ,IL-10和血小板计数的相关性。结果 与健康对照组相比,ITP患者PBMC中TRAIL表达显著增高(2.80±0.43 vs 1.00±0.24,t=19.72,P<0.001)。与健康对照组相比,ITP患者血清中IFN-γ和TNF-α升高(52.43±11.04 pg/ml vs 23.26±8.15 pg/ml;69.14±10.89 pg/ml vs 36.14±13.17 pg/ml,t=10.36~11.50,P值均<0.001),IL-10降低(11.18±6.13 pg/ml vs 33.28±9.85 pg/ml,t=10.17,P<0.001),IL-4的变化差异无统计学意义(35.75±12.52 pg/ml vs 40.16±14.26 pg/ml,t=1.25,P>0.05)。且ITP患者TRAIL的表达与血清中IFN-γ,TNF-α正相关(r=0.432,0.541,P值均<0.05),与IL-10,血小板计数负相关(r=-0.424,-0.553,P值均<0.05)。结论TRAIL可能通过介导细胞因子免疫紊乱,参与了ITP的发生与发展,这为进一步研究ITP的免疫干预治疗提供了新的线索和思路。更多还原

【Abstract】 Objective To explore TRAIL expression in patients with primary immune thrombocytopenia(ITP) and its role in the pathogenesis.Methods Peripheral Blood Mononuclear Cells(PBMCs) from twenty-eight patients with ITP and thirty healthy controls were obtained.TRAIL expression was determined using Real-time Quantitative Polymerase Chain Reaction(RT-PCR).Serum TNF-α,IFN-γ,IL-4 and IL-10 were detected using ELISA.Associations between TRAIL expression and clinical parameters were assessed.Results Compared to healthy controls.TRAIL expression was significantly increased in PBMC from patients with ITP(2.80±0.43 vs 1.00 ±0.24,t= 19.72,P<0.001).Compared to the healthy controls,expression of IFN-γ and TNF-α from ITP patients were increased(52.43 ± 11.04 pg/ml vs 23.26 ± 8.15 pg/ml;69.14 ±10.89 pg/ml vs 36.14±13.17 pg/ml,t= 10.36- 11.50,P<0.001) and expression of IL-10 were decreased(11.18±6.13pg/ml vs 33.28±9.85 pg/ml,t=10.17,P<0.001) and there was no significant difference in IL-4 expression(35.75±12.52 pg/ml vs 40.16±14.26 pg/ml,t=1.25,P>0.05).Furthermore,TRAIL expression was positively correlated with serum IFN-γ,TNF-α level(r= 0.432,0.541,P<0.05),and negatively correlated with IL-10 and PLT(r=-0.424,-0.553,P<0.05).Conclusion Rur results suggest that TRAIL may be involved in the pathogenesis of ITP.更多还原