免疫性血小板减少症患者调节性B细胞数量及功能

Quantity and function of regulatory B cells of the patients with immune thrombocytopenia

目的 探讨免疫性血小板减少症（ITP）患者外周血中调节性B细胞（Breg）数量及功能变化.方法 选取2013年11月至2014年10月天津医科大学总医院血液科住院的初诊ITP患者35例、完全缓解ITP患者32例及健康志愿者30名.采用流式细胞术检测其外周血Breg数量（CD19^＋ CD24^hiCD38^hi/CD19^＋）及其功能分子白细胞介素10（IL-10）表达量,并将Breg与ITP患者的免疫状态及血小板计数进行相关性分析.结果 外周血Breg占CD19^＋淋巴细胞比例：ITP初诊患者（3.09％±2.57％）显著低于完全缓解患者（7.78％±6.59％,P =0.002）和健康对照（5.42％±3.31％,P=0.003）.外周血Breg中IL-10^＋细胞比例：初诊患者比例（32.30％±12.71％）低于完全缓解患者（71.73％±18.08％,P=0.000）和健康对照（51.01％ ±17.08％,P=0.026）,完全缓解患者高于健康对照（P =0.026）.Breg与髓样树突细胞（mDC）数量呈正相关（r=0.644,p=0.003）,与外周血血小板计数呈正相关（r=0.327,P=0.006）.结论 Breg参与了ITP的发病,是其潜在的治疗靶点.

Objective To explore the quantity and function of regulatory B cells （Bregs） in peripheral blood （PB）of the patients with immune thrombocytopenia（ITP）.Methods A total of 67 ITP patients （35 patients were newly diagnosed,32 patients were in remission） were collected from November 2013 to October 2014 in our hospital.And 30 normal controls were enrolled in this study.Their PB Bregs （CD19^＋ CD24^hiCD38^hicells） and related molecules interleukin-10（IL-10） in Bregs were detected by flow cytometry （FCM）.Correlation between Bregs and clinical parameters of ITP patients was analysed.Results The percentage of Bregs in CD19 ^＋ cells of newly diagnosed ITP patients（3.09% ± 2.57%）was significantly lower than that of remitted ITP patients （7.78% ± 6.59%,P =0.002） and controls （5.42% ± 3.31%,P =0.003）.The percentage of IL-10 ^＋ cells in Bregs of newly diagnosed ITP patients （32.30% ± 12.71%） was significantly lower than that of remitted ITP patients （71.73% ± 18.08%,P =0.000） and controls （51.01% ± 17.08%,P =0.026）.And the percentage of IL-10^ ＋ cells in Bregs of remitted ITP patients was significantly higher than that of controls （P =0.026）.The level of Bregs of newly diagnosed ITP patients had significantly positive correlation with myeloid dendritic cells （mDC） （r =0.644,P =0.003） and PB platelet count（r =0.327,P =0.006）.Conclusion Bregs involved in the pathogenesis of ITP might be a potential therapeutic target of this disease.