原发免疫性血小板减少症患者CD4^＋T细胞CD28的表达及其与IFN-γ/IL-10比率的关系

CD28 expression on CD4^+T cells and its relationship with IFN-γ/IL-10 ratio in patients with primary immune thrombocytopenia

目的研究原发免疫性血小板减少症(ITP)患者治疗前、后,外周血CD4+的T淋巴细胞中共刺激分子CD28的表达及与IFN-γ/IL-10比率的关系。方法采用流式细胞术分析30例ITP患者糖皮质激素治疗前、后和26例正常对照外周血CD4+T细胞上CD28表达率,用ELISA双夹心法检测外周血血清中IFN-γ和IL-10的水平,评价CD4+CD28+与IFN-γ/IL-10平衡状态、血小板计数之间的关系。结果 ITP患者治疗前CD4+CD28+的表达显著高于正常对照组(P<0.05),治疗后与正常对照组比较,差异无统计学意义(P>0.05);ITP患者治疗前IFN-γ水平较正常对照组显著增高,IL-10水平显著降低,IFN-γ/IL-10比值显著增高(P<0.01),治疗后与正常对照组比较,差异无统计学意义(P>0.05);ITP患者治疗前CD4+CD28+与IFN-γ/IL-10比值呈正相关(P<0.05),与血小板计数呈负相关(P<0.05)。结论共刺激分子CD28与ITP免疫紊乱密切相关,可能通过参与Th1优势状态形成而在ITP的发病中发挥一定作用。

Objective To investigate CD28 expression on CD4^ ＋T cells and its relationship with IFN-γ/IL-10 ration in patients with primary immune thrombocytopenia （ITP） before and after treatment. Methods The expression of CD4^ ＋ CD28 ^＋ was detected by flow cytometry, the levels of IFN-γ and IL-10 were determined by double-antibody sandwich ELISA and platelet count was tested by blood cells automatical counter in peripheral blood of 30 patients with ITP before and after glucocorticoid treatment and 26 cases of normal controls. Then the correlations between the outcomes were analyzed. Results The expression of CEH^＋ CD28^＋ of ITP patients before treatment was higher than that of the normal control group （ P 〈 0. 05）, however, after treatment the expression between the two groups had no statistical difference （ P 〉 0.05 ）. Compared with the control group, the ITP patients before treatment showed the significantly higher level of IFN-γ and the significantly decreased level of IL-10, and the ratio of IFN-γ/IL-10 was significantly raised （P 〈 0.01 ） ; while ITP patients after treatment had no statistically significant difference in the above indexes from the normal controls （P〉 0.05）. Moreover, CD4^＋ CD28^＋ was positively correlated with IFN-γ/IL-10 ratio （P〈 0.05）, and was negatively correlated with platelet count in ITP patients before treatment （ P 〈 0. 05）. Condusion Co-stimulatory molecule CD4^＋ CD28^＋ was closely related with immune disorder of ITP. It maybe played a role in the pathogenesis of ITP through involving Thl advantage state formation.