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免疫性血小板减少症患者骨髓滤泡辅助性T细胞数量及功能的研究

Quantity and Function of T Follicular Helper Cells in the Bone Marrow of Patients with Immune Thrombocytopenia

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【作者】 张洋瞿文阮二宝付蓉王国锦刘鸿王晓明吴玉红宋嘉邢莉民关晶李丽娟王化泉邵宗鸿

【Author】 ZHANG Yang;QU Wen;RUAN Er-Bao;FU Rong;WANG Guo-Jin;LIU Hong;WANG Xiao-Ming;WU Yu-Hong;SONG Jia;XING Li-Min;GUAN Jing;LI Li-Juan;WANG Hua-Quan;SHAO Zong-Hong;Department of Hematology,Tianjin Medical University General Hospital;

【机构】 天津医科大学总医院血液科

【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。

【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.

【基金】 国家自然科学基金(81170472,81370607);天津市自然科学基金重点项目(12JCZDJC21500);天津市抗癌重大专项攻关计划(12ZCDZSY17900,12ZCDZSY18000);天津市卫生行业重点攻关项目(11KG135);卫生行业科研专项项目(201202017)
  • 【文献出处】 中国实验血液学杂志 ,Journal of Experimental Hematology , 编辑部邮箱 ,2014年03期
  • 【分类号】R558.2
  • 【被引频次】13
  • 【下载频次】197
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