CAJ | 학술논문

目的：研究慢性特发性血小板减少性紫癜（CITP）患儿外周血调节性 B 细胞数量与相关细胞因子的变化，分析它们之间的相关性，研究这些细胞的分化在 CITP 发病机制中的作用。方法选择30例 CITP 患儿，外周血单个核细胞被分离，Breg细胞以及 Th1、Th22、Th17的比例变化通过流式细胞术检测；并体外培养 PBMC 细胞，上述培养液中 IL-10水平以及 IFN-γ、IL-17、IL-22运用 ELISA 法检测，与同期选择的健康组比较。结果与健康组比较，CITP 患儿外周血中 Th1、Th17、Th22细胞亚群的比例均升高（18．4±4．7 vs 10．82±4．4；2．42±1．02 vs 1．23±0．42；0．79±0．24 vs 0．26±0．11，％），调节性 B 细胞（Breg）的比例降低（0．83±0．21 vs 1．89±0．12，％），差异均有统计学意义（P ＜0．05），Breg 细胞分别与 Th 效应细胞亚群的变化呈负相关（P ＜0．05），细胞因子 IL-10水平与 IFN-γ、IL-17、IL-22水平也呈负相关（P ＜0．05）。结论调节性 B 细胞比例下调可能参与CITP 患儿效应 T 细胞免疫紊乱机制，为 CITP 患儿的免疫调节治疗提供了新思分路。
목적：연구만성특발성혈소판감소성자전（CITP）환인외주혈조절성 B 세포수량여상관세포인자적변화，분석타문지간적상관성，연구저사세포적분화재 CITP 발병궤제중적작용。방법선택30례 CITP 환인，외주혈단개핵세포피분리，Breg세포이급 Th1、Th22、Th17적비례변화통과류식세포술검측；병체외배양 PBMC 세포，상술배양액중 IL-10수평이급 IFN-γ、IL-17、IL-22운용 ELISA 법검측，여동기선택적건강조비교。결과여건강조비교，CITP 환인외주혈중 Th1、Th17、Th22세포아군적비례균승고（18．4±4．7 vs 10．82±4．4；2．42±1．02 vs 1．23±0．42；0．79±0．24 vs 0．26±0．11，％），조절성 B 세포（Breg）적비례강저（0．83±0．21 vs 1．89±0．12，％），차이균유통계학의의（P ＜0．05），Breg 세포분별여 Th 효응세포아군적변화정부상관（P ＜0．05），세포인자 IL-10수평여 IFN-γ、IL-17、IL-22수평야정부상관（P ＜0．05）。결론조절성 B 세포비례하조가능삼여CITP 환인효응 T 세포면역문란궤제，위 CITP 환인적면역조절치료제공료신사분로。
Objective To study the changes of the peripheral blood regulatory B cells and related cytokines in children patients with chronic idiopathic thrombocytopenic purpura (CITP),and to analyze their correlations with effective Th cells,and to discuss their roles in the pathogenesis of CITP.Methods The peripheral blood mononuclear cells (PBMC)were separated in 30 cases of CITP,then percentages of Th1 ,Th17,Th22 and Breg cells were detected by the flow cytometry(FCM).IFN-γ,IL-17,IL-22 and IL-10 levels in culture supernatant were measured by the ELISA method.Results Compared with the control group,the proportions of the peripheral blood Th1 ,Th17,Th22 subsets in CITP children were increased[(18.4±4.7)% vs.(10.82±4.4)%;(2.42±1.02 )% vs.(1 .23±0.42)%;(0.79±0.24)% vs.(0.26±0.11)%],the proportion of Breg cells was reduced significantly,the differ-ences had statistical significance[(0.83±0.21)% vs.(1 .89±0.12)%,P <0.05].In CITP children,the IFN-γ,IL-17,IL-22 levels in culture supernatant were higher than those in the control group[(278.2±121.2)pg/mL vs.(181.8 ±82.2)pg/mL;(214.8 ± 100.5)pg/mL vs.(161 .4±67.8)pg/mL;(122.16±22.2)pg/mL vs.(90.8±31.1)pg/mL],but the IL-10 level was lower than that in the healthy control group[(27.4±12.6)pg/mL vs.(46.1±16.2)pg/mL),differences between them had statistical signifi-cance(P <0.05).Besides,there was a positive correlation between the proportion of Breg cells and cytokine IL-10 level(r=0.617, P <0.05 ),however,there was a negative correlation between the proportion of Breg cells with Th1 ,Th17 and Th22 cells (P <0.05),between IL-10 level with IFN-γ,IL-17 and IL-22 levels(P <0.05).Conclusion The downregulation of Breg cells proportion may participate in the immune disorder mechanism of effective Th cells in CITP children,which can provide a new idea for the im-munoregulation therapy in CITP children.