CAJ | 학술논문

目的探讨特发性血小板减少性紫癜(ITP)患者糖皮质激素治疗效应与外周血单个核细胞(PBMC) Th1/Th2细胞因子表达水平之间的关系.方法选取半定量RT-PCR的方法分别对ITP患者及正常对照组的Th1细胞因子IL-2、TNF-α、IFN-γ的mRNA和Th2细胞因子IL-4、IL-6的mRNA进行了检测;采用ELISA法检测ITP患者及对照组的血浆中的TNF-α含量.结果 IL-2、TNF-α、IFN-γ的mRNA表达量在ITP的患者(激素敏感和激素抵抗组)都明显高于正常对照组(IL-2:1.27±0.67和1.32 ±0.61比1.02±0.57;TNF-α:1.21±0.45和1.59±0.79比1.07±0.51;IFN-γ:1.28±0.49和1.35±0.57比1.11±0.45,P均＜0.05);而IL-4、IL-6的mRNA表达量在ITP患者(激素敏感和激素抵抗组)低于正常对照组(IL-4:1.06±0.51和0.84±0.65比1.37±0.53;IL-6:1.04±0.61和0.98±0.57比1.31±0.52,P均＜0.05);在ITP患者中,激素抵抗组的TNF-α mRNA的表达明显高于激素敏感组和正常对照组(1.59±0.79比1.21±0.45),差异有统计学意义(P＜0.05).ITP患者激素抵抗组和激素敏感组的TNF-α含量都明显高于正常对照组[(13.69±4.92) pg/mL和(19.73±4.66) pg/mL比(7.51±2.79)pg/mL,P＜0.05],而且激素抵抗组的TNF-α含量较激素敏感组增高[(13.69±4.92)pg/mL比(19.73±4.66) pg/mL,P＜0.05].结论 ITP患者表现为Th1细胞因子为主的表达,激素抵抗型ITP患者的TNF-α的表达增高.
목적 탐토특발성혈소판감소성자전(ITP)환자당피질격소치료효응여외주혈단개핵세포(PBMC) Th1/Th2세포인자표체수평지간적관계.방법 선취반정량RT-PCR적방법분별대ITP환자급정상대조조적Th1세포인자IL-2、TNF-α、IFN-γ적mRNA화Th2세포인자IL-4、IL-6적mRNA진행료검측;채용ELISA법검측ITP환자급대조조적혈장중적TNF-α함량.결과 IL-2、TNF-α、IFN-γ적mRNA표체량재ITP적환자(격소민감화격소저항조)도명현고우정상대조조(IL-2:1.27±0.67화1.32 ±0.61비1.02±0.57;TNF-α:1.21±0.45화1.59±0.79비1.07±0.51;IFN-γ:1.28±0.49화1.35±0.57비1.11±0.45,P균＜0.05);이IL-4、IL-6적mRNA표체량재ITP환자(격소민감화격소저항조)저우정상대조조(IL-4:1.06±0.51화0.84±0.65비1.37±0.53;IL-6:1.04±0.61화0.98±0.57비1.31±0.52,P균＜0.05);재ITP환자중,격소저항조적TNF-α mRNA적표체명현고우격소민감조화정상대조조(1.59±0.79비1.21±0.45),차이유통계학의의(P＜0.05).ITP환자격소저항조화격소민감조적TNF-α함량도명현고우정상대조조[(13.69±4.92) pg/mL화(19.73±4.66) pg/mL비(7.51±2.79)pg/mL,P＜0.05],이차격소저항조적TNF-α함량교격소민감조증고[(13.69±4.92)pg/mL비(19.73±4.66) pg/mL,P＜0.05].결론 ITP환자표현위Th1세포인자위주적표체,격소저항형ITP환자적TNF-α적표체증고.
Objective To clarify the relationship between the response of the patients with idiopathic thrombocytopenia purpura (ITP)to glucocorticoid and Th1/Th2 cytokines in peroperal blood mononuclear cell (PBMC).Methods Adult chronic ITP patients were divided to glucocorticoid-sensitive groups and glucocorticoidresistant groups according their responces to glucocorticoid.Healthy volunteers were regarded as controls.The semiquantitative RT-PCR was used to detect the expression of Th1/Th2 cytokines in PBMC.ELISA was used to detect the TNF-α in plasma.Results Compared with controls,the levels of Th1 type cytokines IL-2,TNF-α and IFN-γwere increased in ITP patients (IL-2:1.27 ± 0.67 and 1.32 ± 0.61 vs 1.02 ± 0.57 ;TNF-α:1.21 ± 0.45 and 1.59 ± 0.79 vs 1.07 ± 0.51 ; IFN-γ:1.28 ± 0.49 and 1.35 ± 0.57 vs 1.11 ± 0.45,all P ＜ 0.05),while the levels of Th2 type cytokines IL-4 and IL-6 were decreased in ITP patients (IL-4:1.06 ±0.51 and 0.84 ±0.65 vs 1.37 ±0.53;IL-6:1.04 ± 0.61 and 0.98 ± 0.57 vs 1.31 ± 0.52,all P ＜ 0.05).The expression of TNF-α in plasma of ITP patients with glucocorticoid resistance (19.73 ± 4.66) pg/mL was significantly higher than that in the glucocorticoid-sensitive groups (13.69 ± 4.92) pg/mL and controls (7.51 ± 2.79) pg/mL,all P ＜ 0.05.Conclusions Imbalance of Th1/Th2 type cytokines may be correlated with the pathogenesis of ITP.