成人原发免疫性血小板减少症(ITP)患者髓源性抑制细胞数量及功能研究

Number and Function of Myeloid-Derived Suppressor Cells in Patients with Adult Primary Immune Thrombocytopenia

目的:分析成人ITP患者骨髓中髓源性抑制细胞(myeloid-derived suppressor cells,MDSC)数量及前列腺素E2(PGE2)含量,探讨其参与疾病发病的可能机制。方法:选取初治组ITP患者25例、完全缓解组ITP患者25例及正常对照组15例。采用流式细胞术(FCM)检测3组患者骨髓中MDSC数量。采用酶联免疫吸附试验法(ELISA)测定3组患者骨髓血清中PGE2含量。采用实时荧光定量聚合酶链式反应(RT-q PCR)测定3组患者骨髓单个核细胞内IFN-γmRNA相对表达水平。结果:成人ITP完全缓解患者组MDSC数量明显高于正常对照组(P<0.05);初治组M DSC数量高于正常对照组;完全缓解组M DSC数量高于初治组。初治组ITP患者骨髓血清中PGE2含量高于正常对照组(P<0.05);完全缓解组ITP患者骨髓血清中PGE2含量高于对照组(P<0.05);初治组ITP患者骨髓血清中PGE2含量低于完全缓解组患者(P<0.05)。初治组ITP患者骨髓单个核细胞中IFN-γ的相对表达水平均明显高于正常对照组和完全缓解组(P<0.001)。初治组与完全缓解组患者骨髓单个核细胞中IFN-γ的基因定量比值(RQ)为2.60。结论:成人ITP疾病缓解时,M DSC数量上升,且和治疗反应和骨髓中PGE2含量呈正相关。

Objective： To analyze the number of myeloid-derived suppressor cells（ MDSC） and the level of prostaglandin E2（ PGE2） in the bone marrow of adult ITP patients,and to explore their possible mechanisms involved in the pathogenesis of this disease. Methods： Twenty-five patients of newly diagnosed ITP,25 patients of complete remission group and 15 patients of control group were selected. The number of MDSC in the bone marrow between 3 groups was detect by flow cytometry（ FCM）. The serum level of prostaglandin E2（ PGE2） in 3 groups was determined by enzyme linked immunosorbent assay（ ELISA）. The relative expression of IFN-γ mRNA in bone marrow mononuclear cells was measured by real time fluorescence quantitative polymerase chain reaction（ RT-qPCR） in each groups. Results： The number of MDSC in the complete remission group was significantly higher than that in the control group（ P〈0. 05）; the number of MDSC in the newly diagnosed group was higher than that in the control group; the number of MDSC in the complete remission group was higher than that in the newly diagnosed group. The serum level of PGE2 in bone marrow of ITP patients in the newly diagnosed group was higher than that of the control group（ P〈0. 05）.The serum level of PGE2 in the bone marrow of ITP patients of the complete remission group was higher than that of the control group（ P〈0. 05）. The level of PGE2 in bone marrow serum of ITP patients of the newly diagnosed group was lower than that in the complete remission group（ P〈0. 05）. The relative expression level of IFN-gamma in bone marrow mononuclear cells of the ITP patients in newly diagnosed group was higher than that in the control group and the complete remission group（ P〈0. 001）. The relative quantification（ RQ） of IFN-γ in bone marrow mononuclear cells was 2. 60 between the newly diagnosed group and the complete remission group. Conclusion： When adult ITP disease is remitted,the number of MDSC rises and correlates with the therapeutic response and PGE2 level in the bone marrow.