免疫性血小板减少症患者CD19^+B细胞的表达及血清Breg在患者发病中的参与作用

Expression of CD19^+B Cells and Involvement of Serum Breg in Pathogenesis of Immune Thrombocytopenia

目的:研究免疫性血小板减少症(ITP)患者CD19^+B细胞的表达,分析血清Breg在ITP患者中的变化和影响。方法:选取2015年8月至2018年8月期间本院血液科收治的初次诊断为ITP患者68例(ITP组),选取同时段到我院体检中心的30例健康人(对照组),采用流式细胞术测定2组外周血淋巴细胞亚群CD19^+的表达率和外周血Breg细胞表达水平,对比治疗前、后ITP组与对照组之间的差别;采取RT-PCR检测各组IL-10mRNA、TGF-β1 mRNA水平,分析ITP患者外周血Breg细胞比值与IL-10 mRNA、TGF-β1 mRNA表达的相关性。结果:治疗前,ITP组CD19^+表达率显著高于对照组,两组间差异具有统计学意义。ITP组血清Breg细胞表达水平较对照组血清Breg细胞表达水平低;初诊ITP组IL-10 mRNA水平较对照组明显减低,治疗后其IL-10 mRNA水平较治疗前显著升高,差异具有统计学意义。此外,初诊ITP组TGF-β1 mRNA水平较对照组明显升高,治疗后其TGF-β1 mRNA水平较治疗前有所降低;外周血Breg细胞比值与IL-10 mRNA表达呈正相关(r=0.968,P <0.05),但外周血Breg细胞比值与TGF-β1 mRNA表达无相关性(r=0.502,P>0.05)。结论:ITP患者CD19^+细胞表达增强,临床中Breg细胞参与ITP发生发展,Breg细胞表达异常与ITP的发病有关。

Objective:To study the expression of CD19^+B cells in immune thrombocytopenia patients,and to analyze the involvement of serum Breg in the pathogenesis of ITP.Methods:A total of 68 ITP patients admitted in department of hematology in our hospital from August 2015 to August 2018 were selected and enrolled in ITP group.30 healthy individuals who were admitted to physical examination center at the same time were selected and enrolled in control group.The expression of peripheral blood lymphocyte subsets CD19^+and peripheral blood Breg cells were measured by flow cytometry.The difference between the ITP group and the control group was compared.The IL-10 mRNA and TGF-β1 mRNA levels were detected by RT-PCR.Correlations between the ratio of peripheral blood Breg cells and the expression of IL-10 mRNA and TGF-β1 mRNA in patients with immune thrombocytopenia,were analyzed.Results:Expression of CD19^+in ITP group was significantly higher than that in control group.The difference between the two groups was statistically significant.Expression level of serum Breg cells in ITP group was lower than that in control group.IL-10 mRNA level in ITP group was significantly lower than that in control group.IL-10 mRNA level after treatment was significantly higher than that before treatment.In addition,TGF-β1 mRNA level in newly diagnosed ITP group was significantly higher than that in control group.After treatment,the TGF-β1 mRNA level was higher than that before treatment.The ratio of peripheral blood Breg cells positively correlated with IL-10 mRNA expression(r=0.968,P<0.05),however,there was no correlation between peripheral blood Breg cell ratio and TGF-β1 mRNA expression(r=0.502,P>0.05).Conclusion:Expression of CD19^+cells in ITP patients is increased.Breg cells may participate in the genesis of immune thrombocytopenia.The abnormal expression of Breg cells relates with the pathogenesis of immune thrombocytopenia.