甲泼尼龙琥珀酸钠对急性原发免疫性血小板减少症患者Tr细胞分化及FoxP3基因表达的影响

Effect of methylprednisolone sodium succinate on Tr cell differentiation and FoxP3 gene expression in patients with acute idiopathic thrombocytopenic purpura

目的探究甲泼尼龙琥珀酸钠对急性原发免疫性血小板减少症(AITP)患者调节性T(Tr)细胞分化及叉头蛋白P3(FoxP3)基因表达的影响。方法选取该院在2017年1月至2018年1月间收治的56例AITP患儿作为研究对象(AITP组),给予甲泼尼龙琥珀酸钠治疗,并选择同期56例健康体检儿童作为健康组。比较AITP患儿治疗效果,以及治疗前、后外周血T细胞亚群、细胞因子(IL-10、TGF-β1)、FoxP3mRNA表达情况。结果AITP组患儿治疗后血小板计数较治疗前升高(134.18±0.12)×10~9/L,平均水平为(95.11±29.62)×10~9/L;皮肤黏膜紫癜平均消退时间为(44.01±7.48)h。AITP组患儿治疗前外周血CD4^+CD25^+Tr细胞、CD4^+Tr细胞、CD25^+Tr细胞、CD4^+CD25^+Tr细胞/CD4^+Tr细胞水平低于健康儿童(P<0.05);AITP组患儿治疗后外周血CD4^+CD25^+Tr细胞、CD4^+Tr细胞、CD25^+Tr细胞、CD4^+CD25^+Tr细胞/CD4^+Tr细胞水平高于治疗前(P<0.05)。AITP患儿治疗前外周血FoxP3mRNA表达水平低于健康组(P<0.05);AITP组患儿治疗后FoxP3mRNA表达水平高于治疗前(P<0.05)。结论 AITP患儿外周血CD4^+CD25^+Tr细胞数量、FoxP3表达水平明显降低,甲泼尼龙琥珀酸钠治疗AITP效果显著,可提高外周血CD4^+CD25^+Tr细胞数量及FoxP3表达水平。

Objective To investigate the effect of methylprednisolone sodium succinate on the differentiation of Tr cells and FoxP3 gene expression in patients with acute idiopathic thrombocytopenic purpura(AITP).Methods Fifty-six children with AITP admitted to this hospital from January 2017 to January 2018 were selected as the study subjects(AITP group).Methylprednisolone sodium succinate was given to them.Fifty-six healthy children were selected as the health group at the same time.To compare the therapeutic effect of AITP and the expression of T cell subsets,cytokines(IL-10,TGF-beta 1)and FoxP3 mRNA in peripheral blood before and after treatment.Results After treatment,the platelet count increased(134.18±50.12)×10^9/L,and the average regression time of the skin mucous purpura was(44.01±7.48)h.The levels of CD4^+CD25^+,CD4^+,CD25^+and CD4^+CD25^+/CD4^+Tr cells in peripheral blood of the AITP group were lower than those of the health group(P<0.05).The levels of CD4^+CD25^+,CD4^+,CD25^+and CD4^+CD25^+/CD4^+Tr cells in peripheral blood of children with AITP were higher than those before treatment(P<0.05).The expression level of FoxP3 mRNA in peripheral blood of AITP group was lower than that of the health group(P<0.05).The expression level of FoxP3 mRNA in children with ITP was higher than that before treatment(P<0.05).Conclusion The expression level of CD4^+CD25^+Tr cells,FoxP3 in peripheral blood of children with AITP were significantly reduced.Methylprednisolone sodium succinate is effective in the treatment of AITP,through improving the number of CD4^+CD25^+Tr cells in peripheral blood and FoxP3 expression.