IL-35在原发性免疫性血小板减少症中表达及临床意义

Expression and clinical significance of IL-35 in idiopathic immune thrombocytopenia

目的研究原发性免疫性血小板减少症(primary immune thrombocytopenia,ITP)患者外周血中白细胞介素-35(interleukin-35,IL-35)的表达水平,并探讨其在ITP发病机制中的作用及临床意义。方法收集2018年1月至2019年8月中国人民解放军联勤保障部队第九○一医院32例初诊ITP患者(实验组)和30例健康志愿者(对照组)外周血,采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测ITP患者外周血中IL-35水平,反转录PCR(reverse transcription PCR,RT-PCR)检测P35和EBI3 mRNA水平,并分析IL-35与初诊ITP患者临床指标的相关性。结果与对照组相比,初诊ITP患者外周血中IL-35[(12.08±8.65)pg/mL比(32.15±9.26)pg/mL]和P35 mRNA表达水平[(8.29±3.58)比(18.14±5.06)]明显降低(P值均<0.05),EBI3 mRNA水平未见明显差异(P>0.05),ITP患者外周血中IL-35水平与血小板数量呈正相关(r=0.556,P<0.05),ITP患者经治疗后,IL-35表达水平较治疗前明显恢复[(28.38±6.32)pg/mL比(11.68±7.65)pg/mL,P<0.05]。结论IL-35可能与ITP患者体内存在的免疫耐受功能紊乱有关,并可能成为监测ITP患者疾病活动及疗效的新指标。

Objective To investigate the expression and pathogenesis role of interleukin-35(IL-35)in peripheral blood of patients with idiopathic immune thrombocytopenia(ITP).Methods From January 2018 to August 2019.Peripheral blood sample of 32 newly diagnosed ITP patients and 30 healthy volunteers were collected in the 901th Hospital of the Joint Logistics Support Force of PLA.The levels of IL-35 in peripheral blood of patients with ITP were detected by enzyme linked immunosorbent assay(ELISA),and the levels of P35 and EBI3 mRNA were detected by RT-PCR method.The correlation between IL-35 and annual clinical indexes of newly diagnosed ITP patients was analyzed.Results The expression level of IL-35[(12.08±8.65)pg/mLvs(32.15±9.26)pg/mL]and P35 mRNA[(8.29±3.58)vs(18.14±5.06)]in peripheral blood of patients with newly diagnosed ITP was significantly lower than that of the control group(both P values<0.05),and there was no significant difference in the level of EBI3 mRNA.The level of IL-35 was positively correlated with the number of platelets(r=0.556,P<0.05).After treatment,the expression level of IL-35[(28.38±6.32)pg/mL vs(11.68±7.65)pg/mL,P<0.05]was significantly higher than that before treatment.Conclusion IL-35 may be related to the disturbance of immune tolerance in patients with ITP,and may be a new index to monitor the disease activity and curative effect in patients with ITP.