摘要目的 探讨调节性T细胞和Th17细胞比值在特发性血小板减少性紫癜(ITP)发病机制中的作用.方法 应用流式细胞术检测29例ITP患者和28名正常人外周血中CD4+CD25+T细胞、CD4+CD25high T细胞、CD4+IL-17A+T细胞的数量,ELISA法测定血浆中IL-10、IL-17水平;RT-PCR法检测外周血Foxp3和RORc mRNA的表达水平.结果 与正常对照组比较,ITP患者外周血CD4+CD25+T细胞/CD4+T细胞比值升高(P＜0.05),CD4+CD25high T细胞/CD4+T细胞比值下降(P＜0.05),CD4+IL-17A+T细胞/CD4+T细胞比值差异无统计学意义(P＞0.05),CD4+CD25highT细胞/CD4+IL-17+T细胞比值从11.42±5.09降低为1.08±0.84(P＜0.05).ITP患者血浆IL-10水平明显低于正常对照组(P＜0.05),IL-17水平与对照组比较无显著差异(P＞0.05).ITP患者较正常对照组外周血中Foxp3 mRNA水平明显降低(P＜0.05),而RORc mRNA表达则较对照组明显升高(P＜0.05).结论 ITP患者存在调节性T细胞/Th17细胞比例平衡失调,其可能在ITP免疫发病机制中起一定作用.

abstractsObjective To investigate the expression of regulatory T cells and Th17 cells in idiopathic thrombocytopenic purpura (ITP) and its significance. Methods The quantity of CD4 + CD25 + T cells,CD4+ CD25high T cells and CD4+ IL-17+ T cells in peripheral blood were measured with flow cytometry (FCM), the plasma level of IL-10 and IL-17 with ELISA and the expression of Foxp3 mRNA and RORc mRNA with RT-PCR in 29 newly diagnosed ITP patients and 28 healthy controls. Results The ratio of CD4 + CD25 + T cells/CD4 + T cells in the peripheral blood of ITP patients was significantly higher than that of the normal controls (P ＜0.05 ). And the ratio of CD4 + CD25highT/CD4. + T cells in the patients was remarkably lower (P＜0.05). There was no difference in the percentage of CD4+ IL-17+T/CD4+ T cells between ITP patients and controls(P ＞0.05 ). The ratio of Treg/Th17 was lower in ITP patients ( P ＜ 0. 05 ). The plasma level of IL-10 in ITP patients was significantly decreased (P＜0.05), whereas no statistical difference was observed in the level of IL-17 (P＞0.05). The Foxp3 mRNA expression levels were largely reduced (P ＜ 0.05), but the RORc mRNA expression was increased compared with that in controls (P＜0.05).Conclusion The imbalance of Treg/Th17 plays an important role in the pathogenesis of ITP.