B10细胞及相关因子异常在CITP免疫紊乱中的作用

Role of regulatory B10 subsets and related cytokines in immune disorder in patients with chronic idiopathic thrombocytopenic purpura

目的检测慢性特发性血小板减少性紫癜(CITP)患者外周血新型调节性B细胞(B10)数量与相关细胞因子的变化,分析患者B10细胞与血小板计数及血小板抗体的相关性,探讨B10在CITP免疫紊乱中的作用。方法选择40例CITP患者,分离外周血单个核细胞(PBMC),采用流式细胞术(FCM)检测B10细胞亚群的比例变化;用ELISA法检测培养液上清中细胞因子IL-10与TGF-β1的水平,FCM法检测患者血小板抗体阳性率的变化,与健康对照组比较分析。结果 CITP患者外周血中CD19+B、CD5+CD19+B细胞亚群的比例均升高,而调节性B10的比例降低(t=5.52,P﹪0.05),并与血小板计数呈正相关(r=0.621,P<0.05),与血小板抗体的水平呈负相关性(r=-0.518,P<0.05);患者PBMC培养液上清IL-10、TGF-β1的水平低于健康对照组,差异有统计学意义(P﹪0.05);患者B10的比例变化与IL-10表达水平呈正相关(r=0.687,P<0.05),而与TGF-β1的变化无相关性(r=0.053,P>0.05)。结论 B10细胞及相关细胞因子IL-10的下调参与CITP的免疫紊乱机制,这将可为CITP的临床诊断与治疗提供新靶点。

Objective To study the role of B10 subsets and related cytokines in immune disorder of patients with chronic idiopathic thrombocytopenic purpura（CITP）.Methods B10 subsets in peripheral blood were detected by flow cytometry（FCM） and the expression levels of IL-10 and TGF-β1 were detected in culture medium of peripheral blood mononuclear cells（PBMC） from 40 CITP cases and 40 controls by ELISA,the platelet related antibody（PAIgG） was analyzed by FCM.Results The proportion of CD19＋B,CD5＋CD19＋B subsets were improved,but the proportion of B10 subsets decreased in comparison with normal controls,showing statistically significant difference（P0.05）.B10 was positively correlated with platelet counts（P0.05）,and negatively with PAIgG（P0.05）.The levels of IL-10 and TGF-β1 were lower in culture medium of PBMC from CITP patients than that of controls（P0.05）,B10 subsets were positively correlated with the levels of IL- 10（P0.05） and not associated with the levels of TGF-β1（P0.05）.Conclusion The lower expression of B10 subsets and related cytokines may involve in the pathogenesis of immune disorder in CITP patients and this may provide a new way for diagnosis and treatment of CITP.