原发免疫性血小板减少症患者PBMC中CD200/CD200R1表达及临床意义

Expression of CD200/CD200R1 from Peripheral Blood Mononuclear Cells of Primary Immune Thrombocytopenia and Its Clinical Significance

目的 检测CD200/CD200R1信号通路分子在原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)患者外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中的表达情况并分析其临床意义。方法 采用实时荧光定量PCR法检测ITP患者组(n=19)和健康对照组(n=19)PBMC中CD200/CD200R1的表达情况。ELISA法检测ITP患者血清中TNF-α,IFN-γ及IL-17细胞因子的表达。分析ITP患者中CD200/CD200R1与细胞因子及血小板计数的相关性。监测有效治疗后ITP患者CD200/CD200R1的变化情况。结果 与健康对照组比,ITP组PBMC中CD200/CD200R1的表达下降,且与患者血小板计数呈正相关。ITP患者血清中细胞因子TNF-α,IFN-γ及IL-17上调,其中TNF-α和IL-17的表达和与CD200及CD200R1的表达量间均呈负相关。经地塞米松治疗有效的ITP患者PBMC中,CD200及CD200R1的表达呈上升趋势。结论 CD200/CD200R1在ITP患者中表达降低,减少了对炎性因子分子表达的抑制作用,因此炎性因子表达增高,从而参与了ITP疾病的发生发展。

Objective To investigate the expression of CD200/CD200R1 in the PBMC of primary immune thrombocytopenia patients and its clinical significance.Methods The mRNA relative expression of CD200/CD200R1 in ITP patients (n=19) and healthy controls (n=19) were measured by RT-PCR.Then we determined the protein levels of TNF-α,IFN-γ and IL-17 in plasma.We further analyzed the correlation between CD200/CD200R1 expression and platelet counts.The changes of CD200/CD200R1 after effective treatment were also be tested by RT-PCR.Results Compared to healthy controls,CD200/CD200R1 were decreased in ITP patients.TNF-α,IFN-γ and IL-17 protein expressions were increased compared with healthy controls.TNF-α and IFN-γ were negatively correlated with CD200/CD200R1,and the platelet counts in ITP patients were positively correlated with CD200/CD200R1.Moreover,after effective treatment by dexamethasone,the mRNA expression of CD200/CD200R1 showed an obviously increase trend.Conclusion CD200/CD200R1 may be involved in the pathogenesis of ITP and related to the decreased inhibition effect of inflammatory cytokines expression,which provides a new cluefor future immunotherapy.