CAJ | 학술논문

目的探讨调节性T细胞和Th17细胞比值在特发性血小板减少性紫癜(ITP)发病机制中的作用.方法应用流式细胞术检测29例ITP患者和28名正常人外周血中CD4+CD25+T细胞、CD4+CD25high T细胞、CD4+IL-17A+T细胞的数量,ELISA法测定血浆中IL-10、IL-17水平;RT-PCR法检测外周血Foxp3和RORc mRNA的表达水平.结果与正常对照组比较,ITP患者外周血CD4+CD25+T细胞/CD4+T细胞比值升高(P＜0.05),CD4+CD25high T细胞/CD4+T细胞比值下降(P＜0.05),CD4+IL-17A+T细胞/CD4+T细胞比值差异无统计学意义(P＞0.05),CD4+CD25highT细胞/CD4+IL-17+T细胞比值从11.42±5.09降低为1.08±0.84(P＜0.05).ITP患者血浆IL-10水平明显低于正常对照组(P＜0.05),IL-17水平与对照组比较无显著差异(P＞0.05).ITP患者较正常对照组外周血中Foxp3 mRNA水平明显降低(P＜0.05),而RORc mRNA表达则较对照组明显升高(P＜0.05).结论 ITP患者存在调节性T细胞/Th17细胞比例平衡失调,其可能在ITP免疫发病机制中起一定作用.
목적 탐토조절성T세포화Th17세포비치재특발성혈소판감소성자전(ITP)발병궤제중적작용.방법 응용류식세포술검측29례ITP환자화28명정상인외주혈중CD4+CD25+T세포、CD4+CD25high T세포、CD4+IL-17A+T세포적수량,ELISA법측정혈장중IL-10、IL-17수평;RT-PCR법검측외주혈Foxp3화RORc mRNA적표체수평.결과 여정상대조조비교,ITP환자외주혈CD4+CD25+T세포/CD4+T세포비치승고(P＜0.05),CD4+CD25high T세포/CD4+T세포비치하강(P＜0.05),CD4+IL-17A+T세포/CD4+T세포비치차이무통계학의의(P＞0.05),CD4+CD25highT세포/CD4+IL-17+T세포비치종11.42±5.09강저위1.08±0.84(P＜0.05).ITP환자혈장IL-10수평명현저우정상대조조(P＜0.05),IL-17수평여대조조비교무현저차이(P＞0.05).ITP환자교정상대조조외주혈중Foxp3 mRNA수평명현강저(P＜0.05),이RORc mRNA표체칙교대조조명현승고(P＜0.05).결론 ITP환자존재조절성T세포/Th17세포비례평형실조,기가능재ITP면역발병궤제중기일정작용.
Objective To investigate the expression of regulatory T cells and Th17 cells in idiopathic thrombocytopenic purpura (ITP) and its significance. Methods The quantity of CD4 + CD25 + T cells,CD4+ CD25high T cells and CD4+ IL-17+ T cells in peripheral blood were measured with flow cytometry (FCM), the plasma level of IL-10 and IL-17 with ELISA and the expression of Foxp3 mRNA and RORc mRNA with RT-PCR in 29 newly diagnosed ITP patients and 28 healthy controls. Results The ratio of CD4 + CD25 + T cells/CD4 + T cells in the peripheral blood of ITP patients was significantly higher than that of the normal controls (P ＜0.05 ). And the ratio of CD4 + CD25highT/CD4. + T cells in the patients was remarkably lower (P＜0.05). There was no difference in the percentage of CD4+ IL-17+T/CD4+ T cells between ITP patients and controls(P ＞0.05 ). The ratio of Treg/Th17 was lower in ITP patients ( P ＜ 0. 05 ). The plasma level of IL-10 in ITP patients was significantly decreased (P＜0.05), whereas no statistical difference was observed in the level of IL-17 (P＞0.05). The Foxp3 mRNA expression levels were largely reduced (P ＜ 0.05), but the RORc mRNA expression was increased compared with that in controls (P＜0.05).Conclusion The imbalance of Treg/Th17 plays an important role in the pathogenesis of ITP.