髓源性抑制细胞在免疫性血小板减少性紫癜中的临床意义

The clinical significance of myeloid-derived suppressor cells in immune thrombocytopenic purpura

目的探讨髓源性抑制细胞(MDSCs)在免疫性血小板减少性紫癜(ITP)中的作用,为ITP的防治新途径提供理论依据。方法对照组60例健康体检者、研究组55例ITP患者治疗前后分别测定MDSCs、一氧化氮合酶(i NOS)、精氨酸酶(ARG),T细胞亚群。结果研究组外周血中MDSCs比例、i NOS和ARG表达水平均低于对照组(0.78±0.45)%vs.(1.75±0.34)%,(0.54±0.33)mIU/m L vs.(1.02±0.13)mIU/m L,(0.32±0.19)mIU/m L vs.(0.86±0.15)mIU/m L),差异有统计学意义(P=0.002,0.023,0.034)。研究组中治疗达CR及R者,治疗后外周血中MDSCs、CD4^+CD25^+细胞比例均高于发病时(1.65±0.36)%vs.(0.76±0.39)%,(0.95±0.63)%vs.(0.25±0.54)%,差异有统计学意义(P=0.003,0.042)。结论 ITP患者外周血中的MD-SCs较健康者明显下降。MDSCs、Treg细胞可能参与改变ITP患者免疫失衡状态,需要进一步实验证实。

Objective To explore the role of myeloid-derived suppressor cells(MDSCs)in immune throm-bocytopenic purpura(ITP)and provide a theoretical basis for the prevention and treatment of ITP.Methods The peripheral blood of 60 healthy persons(control group)and 55 ITP patients(study group)were detected for MD-SCs,nitric oxide synthase(iNOS),arginine enzyme(ARG),and T cell subgroup.Results The proportion of MDSCs,iNOS and ARG levels in the peripheral blood in study groups were lower than the control group(0.78±0.45)%vs.(1.75±0.34)%,(0.54±0.33)mIU/mL vs.(1.02±0.13)mIU/mL,(0.32±0.19)mIU/mL vs.(0.86±0.15)mIU/mL,the difference was statistically significant(P=0.002,0.023,0.002).The proportion of MDSCs,CD4+CD25+cells in peripheral blood after treatment in study group with therapeutic response was higher than that before treatment(1.65±0.36)%vs.(0.76±0.39)%,(0.95±0.63)%vs.(0.25±0.54)%,and the difference was statistically significant(P=0.003,0.042).Conclusion MDSCs in peripheral blood of ITP patients decrease sig-nificantly.MDSCs and Treg cells may be involved in changing the immune imbalance in ITP patients,which need further experimental confirmation.