外周血miRNA-150与CD19+CD24hiCD38hiBreg细胞在儿童免疫性血小板减少症中的变化及意义

目的探讨外周血miRNA-150与CD19⁺CD24^hiCD38^hiBreg细胞在儿童免疫性血小板减少症（ITP）中变化及意义。 方法选取南通大学附属妇幼保健院在2017年3月至2020年9月接受诊治的ITP患儿93例，其中新诊断ITP患儿（病程＜3个月）56例，持续性ITP患儿（病程3~12个月）37例。另选取本院同期健康体检儿童50例作为对照组。采用实时荧光定量PCR反应测定外周血miRNA-150表达，采用流式细胞术测定CD19⁺CD24^hiCD38^hiBreg细胞表达。 结果ITP患儿外周血miRNA-150表达高于对照组，且CD19⁺CD24^hiCD38^hiBreg细胞表达率低于对照组（P＜0.05）。持续性ITP组外周血miRNA-150表达高于新诊断ITP组，而CD19⁺CD24^hiCD38^hiBreg细胞表达率低于新诊断ITP组（P＜0.05）。全反应（CR）组外周血miRNA-150表达低于反应（R）组和无效（NR）组，且R组低于NR组（P＜0.05）。CR组CD19⁺CD24^hiCD38^hiBreg细胞表达率高于R组和NR组，且R组高于NR组（P＜0.05）。外周血miRNA-150对ITP诊断敏感度和特异度分别为78.18%和60.53%；CD19⁺CD24^hiCD38^hiBreg细胞表达对ITP诊断敏感度和特异度分别为83.63%和71.05%。miRNA-150与PLT呈负相关（r=-0.738），而CD19⁺CD24^hiCD38^hiBreg细胞与PLT呈正相关（r=0.796）。 结论外周血miRNA-150在ITP患儿中高表达，而CD19⁺CD24^hiCD38^hiBreg细胞在ITP患儿中低表达，且外周血miRNA-150和CD19⁺CD24^hiCD38^hiBreg细胞表达与疗效密切相关。

Significance of changes of peripheral blood miRNA-150 and CD19+CD24hiCD38hiBreg cells in children with immune thrombocytopenia

ObjectiveTo explore the significance of changes of peripheral blood miRNA-150 and CD19⁺CD24^hiCD38^hiBreg cells in children with immune thrombocytopenia (ITP). MethodsA total of 93 children with ITP treated at the Department of Hematology of Affiliated Maternity and Child Health Care Hospital of Nantong University from March 2017 to September 2020 were selected, including 56 cases with newly diagnosed ITP (course of disease＜3 months) and 37 cases with persistent ITP (course of disease 3-12 months). Another 50 healthy children were selected as a control group. The expression of miRNA-150 in peripheral blood was detected by real-time PCR, and the expression of CD19⁺CD24^hiCD38^hiBreg cells was detected by flow cytometry. ResultsThe expression of miRNA-150 in peripheral blood of ITP children was higher than that of control group, while the expression rate of CD19⁺CD24^hiCD38^hiBreg cells was lower than of the control group (P＜0.05). The expression of miRNA-150 in the persistent ITP group was higher than that in the newly diagnosed ITP group, while the expression rate of CD19⁺CD24^hiCD38^hiBreg cells was lower than that in the newly diagnosed ITP group (P＜0.05). The expression of miRNA-150 was lower in the complete remission (CR) group than in the remission (R) group and no-remission (NR) group, and in the R group than in the NR group (P＜0.05). The expression rate of CD19⁺CD24^hiCD38^hiBreg cells was higher in the CR group than in the R group and NR group, and in the R group than in the NR group (P＜0.05). The sensitivity and specificity of peripheral blood miRNA-150 for diagnosing ITP were 78.18% and 60.53%, respectively, and those of CD19⁺CD24^hiCD38^hiBreg cells for diagnosing ITP were 83.63% and 71.05%, respectively. The expression miRNA-150 was negatively correlated with platelet count (r=-0.738), while CD19⁺CD24^hiCD38^hiBreg cells were positively correlated with platelet count (r=0.796). ConclusionThe expression of miRNA-150 in peripheral blood is high in children with ITP, while the expression of CD19⁺CD24^hiCD38^hiBreg cells is low in children with ITP. The expression of miRNA-150 and CD19⁺CD24^hiCD38^hiBreg cells in peripheral blood is closely related to the curative effect.