基于lncRNA PVT1表达分析银杏内酯B对ITP患者B淋巴细胞及Treg/Th17免疫失衡的影响

Effects of ginkgolide B on B lymphocyte and Treg/Th17 immune imbalance in ITP patients based on lncRNA PVT1 expression

目的探讨银杏内酯B对原发性免疫血小板减少症(ITP)患者长链非编码RNA浆细胞瘤转化迁移基因1(lncRNA PVT1)、B淋巴细胞和调节性T淋巴细胞/辅助性T淋巴细胞17(Treg/Th17)免疫失衡的影响及其相关性。方法依据双盲法将2021年5月至2023年5月廊坊市中医医院收治的130例ITP患者分为对照组(65例)和观察组(65例)。对照组给予长春地辛治疗,观察组给予银杏内酯B治疗,两组均治疗4周。比较两组患者临床疗效;比较两组患者治疗前后lncRNA PVT1表达、B淋巴细胞亚群[CD19^(+)、B1淋巴细胞]比例、Treg/Th17免疫失衡细胞因子[白细胞介素-17(IL-17)、白细胞介素-21(IL-21)];分析lncRNA PVT1表达与CD19^(+)、B1淋巴细胞比例以及IL-17、IL-21水平的相关性。结果研究过程中对照组失访7例,观察组失访5例,最终分组为对照组58例,观察组60例。治疗后两组患者lncRNA PVT1表达、IL-17、IL-21水平以及CD19^(+)、B1淋巴细胞比例较治疗前均有所降低(P<0.05),观察组治疗后lncRNA PVT1表达、IL-17、IL-21水平以及CD19^(+)、B1淋巴细胞比例明显低于对照组(P<0.05)。与对照组相比,观察组临床疗效更优(P<0.05)。lncRNA PVT1表达与CD19^(+)、B1淋巴细胞、IL-17、IL-21水平均呈正相关(P<0.05)。结论银杏内酯B对ITP患者具有较高临床疗效,可以显著改善其lncRNA PVT1表达、B淋巴细胞比例、Treg/Th17免疫失衡细胞因子水平,值得临床推广。

Objective To investigate the effects of ginkgolide B on long non-coding RNA plasmacytoma variant translocation gene 1(lncRNA PVT1),B lymphocyte and the regulatory T lymphocyte/helper T lymphocyte 17(Treg/Th17)immune imbalance in patients with primary immune thrombocytopenia(ITP),as well as its correlation.Methods According to the double-blind method,130 ITP patients treated at Langfang Hospital of Traditional Chinese Medicine from May 2021 to May 2023 were randomly divided into a control group(65 cases)and an observation group(65 cases).The control group was treated with vincristine,while the observation group received ginkgolide B.Both groups were treated for 4 weeks.The clinical efficacy of the two groups was compared.Additionally,the expression levels of lncRNA PVT1,the proportions of B lymphocyte subpopulations(CD19^(+),B1 lymphocytes)and cytokines related to Treg/Th17 immune imbalance[interleukin-17(IL-17),interleukin-21(IL-21)]were analyzed before and after treatment in both groups.The correlation between lncRNA PVT1 expression and the proportion of CD19^(+),B1 lymphocytes,as well as the levels of IL-17 and IL-21 was also examined analyzed.Results During the study,7 cases were lost to follow-up in the control group and 5 cases in the observation group,resulting in a final distribution of 58 cases in the control group and 60 in the observation group.After treatment,the expression of lncRNA PVT1,the levels of IL-17 and IL-21,and the proportion of CD19^(+)and B1 lymphocytes in the two groups were lower than those before treatment(P<0.05).After treatment,the expression of lncRNA PVT1,the levels of IL-17 and IL-21 and the proportion of CD19^(+)and B1 lymphocytes in the observation group were significantly lower than those in the control group(P<0.05).Additionally,the clinical efficacy in the observation group was superior to that of the control group(P<0.05).The expression of lncRNA PVT1 was positively correlated with the proportion of CD19^(+)and B1 lymphocytes,and the levels of IL-17 and IL-21(P<0.05).Conclusion Ginkgolide B shows high clinical efficacy in patients with ITP,significantly improving lncRNA PVT1 expression,B lymphocyte proportions,and Treg/Th17 immune imbalance cytokine levels.It holds promise for broader clinical application.