特发性血小板减少性紫癜患儿血小板生成素及其受体基因转录水平的研究

The level of serum thrombopoietin and its receptor mRNA in platelets in children with idiopathic thrombocytopenic purpura

目的 探讨急性特发性血小板减少性紫癜 (AITP)患儿血小板生成素 (TPO)及血小板TPO受体c MPLmRNA基因转录水平变化的意义。方法 采用ELISA法检测血清TPO、血小板相关抗体 (PAIgG)水平 ;半定量RT PCR法检测外周血血小板c MPLmRNA的相对量。结果 AITP患儿初治时血浆TPO水平增高 ,血小板c MPLmRNA较低 ;经大剂量甲基强的松龙冲击治疗后 ,伴随血小板计数增高 ,血清TPO水平逐渐下降 ,血小板c MPLmRNA增高 ,且与PAIgG呈负相关。结论 血小板数可调控血清TPO水平 ;AITP患儿初诊时c MPLmRNA基因转录下调 ,可能导致骨髓巨核细胞成熟障碍 ,血小板生成减少 ,是AITP发病的重要因素之一。

Objective To explore the significance of serum thrombopoietin (TPO) and its receptor (c MPL) mRNA changes in platelets in children with acute idiopathic thrombocytopenic purpura (AITP). Methods The serum TPO and platelet associated IgG (PAIgG) were detected by ELISA. The mRNA levels of c MPL in platelets were determined by semi quantitative reverse transcription polymerase chain reaction (RT PCR). Results Before treatments in chidren with ITP the serum TPO levels were mildly elevated and c MPL mRNA levels in platelets were decreased, when compared with normal controls. After the treatment with high does methylprednisolone, the serum TPO levels decrease gradually along with the elevation of platelets. The c MPL mRNA levels in platelets increased with the decrease of PAIgG levels. Conclusion The platelet quantity might regulate the serum TPO level. The down regulated transcription of c MPL mRNA might cause maturity disturbance of megakaryocytes and decrease production of platelets, which may be one of the important factors in the pathogenesis of AITP.