ITP患者外周血Th9、Th17和Treg细胞水平及IL-9、IL-17和TGF-β表达在ITP发病中的作用

Role of Th9, Th17, Treg Cells levels and IL-9, IL-17 and TGF-β Expression in Peripheral Blood of Patients with ITP in Pathogenesis of ITP

目的:检测免疫性血小板减少症(ITP)患者外周血Treg、Th17、Th9细胞水平及转化生长因子-β(TGF-β)、白介素-17(IL-17)、白介素-9(IL-9)表达水平并探讨他们在ITP发病中的意义。方法:对54例ITP患者(病例组)与40例健康体检者(对照组)外周血Treg、Th17、Th9细胞水平,用流式细胞术检测2组外周血中TGF-β、IL-17、IL-9等细胞因子的表达用酶联免疫吸附法测定。结果:病例组外周血Treg细胞比例较对照组显著降低,而Th17、Th9细胞比例较对照组均显著升高(P <0.01)。病例组外周血中细胞因子TGF-β的表达水平较对照组显著降低,而IL-17、IL-9的表达水平较对照组均显著升高(P <0.01)。经Pearson相关性分析发现,病例组外周血Treg细胞比例与血小板计数(Plt)存在正相关关系(r=0.35,P <0.05),而Th17、Th9细胞比例与Plt均存在负相关关系(r=-0.37、-0.43,均P <0.05);病例组细胞因子TGF-β的表达水平与Plt存在正相关关系(r=0.46,P <0.05),而IL-17、IL-9的表达水平与PLT均存在负相关关系(r=-0.48、-0.54,均P <0.05)。结论:ITP患者外周血Treg、Th17、Th9细胞比例异常,伴有细胞因子TGF-β、IL-17、IL-9表达水平异常,提示可能在ITP的免疫发病中发挥着重要作用。

Objective: To detect the levels of Treg, Th17, Th9 cells and expression of transforming growth factor-β(TGF-β), interleukin-17(IL-17) and interleukin-9(IL-9) in peripheral blood of patients with immune thrombocytopenia(ITP) and to explore its role in the pathogenesis of ITP. Methods: Fifty-four patients with ITP(ITP group) and 40 healthy volunteers(control group) were selected in our hospital. The of Treg, Th17 and Th9 cells in peripheral blood of 2 groups were measured by flow cytometry, and the expression of cytokines, such as TGF-β, IL-17 and IL-9 in the peripheral blood of 2 groups were detected by enzyme linked immunosorbent assay(ELISA). Results: The level of Treg cells in the peripheral blood of the ITP group was significantly decreased in comparison with the control group, while the levels of Th17 and Th9 cells significantly increased in comparison with the control group(all P<0.01). The expression of cytokine such as TGF-β in the peripheral blood of the case group significantly decreased in comparison with the control group, while the expression levels of IL-17 and IL-9 significantly increased in comparison with the control group(P<0.01). The results of Pearson correlation analysis showed that there was a positive correlation between the level of Treg cells and platelet count(PLT) in peripheral blood of the ITP group(r=0.35, P<0.05), and there were negative correlation between the level rate of Th17, Th9 cells and Plt count(r=-0.37,-0.43, P<0.05);there was a positive correlation between the expression of the TGF-β in the ITP group and Plt count(r=0.46, P<0.05), while the expression of IL-17 and IL-9 showed negative correlation with PLT(r=-0.48,-0.54, P<0.05). Conclusion: The percentage of Treg, Th17 and Th9 cells in the peripheral blood of patients with ITP is abnormal, and the expression of TGF-β, IL-17 and IL-9 also is abnormal, which may play an important role in the pathogenesis of ITP.