【摘要】 本研究检测免疫性血小板减少症(ITP)患者骨髓滤泡辅助性T细胞(Tfh细胞)数量及功能,探讨Tfh细胞在ITP发病机制中的作用。选取2013年1月至10月在天津医科大学总医院血液科就诊的21例初治ITP患者、20例恢复期ITP患者及18名正常对照者,采用流式细胞术检测骨髓Tfh细胞数量、Tfh细胞功能相关分子CD40L、ICOS、IL-21的表达,采用RT-PCR技术检测BMMNC转录因子BCL-6 mRNA相对表达水平;并将各项指标与疾病严重程度进行相关性分析。结果表明,ITP初治组骨髓CD4+CXCR5+/CD4+细胞比例[(5.532±2.599)%]高于恢复期组[(4.064±2.026)%]和对照组[(4.048±1.413)%](P<0.05);ITP初治组骨髓CD4+CXCR5+ICOS+/CD4+CXCR5+细胞比例[(14.586±8.561)%]高于恢复期组[(12.884±10.161)%]和对照组[(7.487±5.176)%],初治组与对照组相比差异有统计学意义(P<0.05);ITP初治组和恢复期组骨髓CD4+CXCR5+CD40L+/CD4+CXCR5+细胞比例[(15.309±10.756)%]及[(18.242±12.243)%],高于对照组[(8.618±5.719)%](P<0.05);ITP初治组和恢复组骨髓CD4+CXCR5+IL-21+/CD4+CXCR5+细胞比例[(58.560±26.285)%]及[(57.035±30.936)%]高于对照组[(36.289±24.868)%](P<0.05);初治组、恢复组、对照组BCL-6 mRNA的表达水平分别为(1.407±0.264)、(1.149±0.217)和(0.846±0.157),差异均有统计学意义(P值均<0.05)。结论:Tfh细胞在ITP患者的骨髓中数量增加,功能分子表达增多,功能亢进,在ITP发病机制中可能有重要作用。更多还原

【Abstract】 This study was purposed to detect the quantity and function of bone marrow( BM) T follicular helper( Tfh) cells of patients with immune thrombocytopenia,and to explore the role of Tfh cells in the pathogenesis of ITP.Twenty-one newly diagnosed ITP patients,twenty ITP patients in recovery stage and eighteen normal controls were enrolled in this study. The percentages of Tfh cells,Tfh-related molecules ICOS,CD40L,IL-21 in BM were detected by flow cytometry( FCM),and the mRNA expression of BCL-6 in BMMNC was determined by semiquantitive RT-PCR.Correlation of Tfh cell level with the disease severity of ITP patients was analysed. The results showed that the ratio of CD4+CXCR5+/CD4+cells in newly diagnosed ITP patients [( 5. 532 ± 2. 599) %]was significantly higher than that in ITP patients with recovery stage[( 4. 064 ± 2. 026) %]and controls[( 4. 048 ± 1. 413) % ]( P < 0. 05). The ratio of CD4+CXCR5+ICOS+/CD4+CXCR5+cells in newly diagnosed ITP patients [( 14. 586 ± 8. 561) %] was higher than that in recovery stage ITP patients [( 12. 884 ± 10. 161) %] and controls [( 7. 487 ± 5. 176) %]. The differences between newly diagnosed ITP patients and controls were statistically significant( P < 0. 05). The ratio of CD4+CXCR5+CD40L+/CD4+CXCR5+cells in newly diagnosed ITP patients[( 15. 309 ± 10. 756) %]and in ITP patients with recovery stage[( 18. 242 ± 12. 243) %]were significantly higher than that in controls[( 8. 618 ± 5. 719) % ]( P < 0. 05). The ratio of intracytoplasm CD4+CXCR5+IL-21+/CD4+CXCR5+cells in newly diagnosed ITP patients [( 58. 560 ±26. 285) %]and in ITP patients with recovery stage[( 57. 035 ± 30. 936) %]were significantly higher than that in controls[( 36. 289 ± 24. 868) % ]( P < 0. 05). The relative expression levels of BCL-6 mRNA in BMMNC of three groups were( 1. 407 ± 0. 264),( 1. 149 ± 0. 217) and( 0. 846 ± 0. 157),respectively. The differences between 3 groups were significant( P < 0. 05). It is concluded that the quantity and function of Tfh cells in ITP patients increase,which may play an important role in the pathogenesis of ITP.更多还原