骨髓TPO与TGF-β1、TGF-βRⅢ的改变及其相关性在儿童ITP发病中的意义

目的 　探讨骨髓内环境中的血小板生成素 (TPO)、转化生长因子 β1 (TGF -β1 )及巨核细胞中转化生长因子 β1 的Ⅲ型受体 (TGF -βRⅢ )在儿童特发性血小板减少性紫癜 (ITP)发病中的意义。方法 　收集 2 8例急性ITP(AITP)患儿、16例慢性ITP(CITP)患儿和 2 0例相对正常儿童的骨髓 ;用Percoll密度梯度及免疫磁珠法分离骨髓巨核细胞 ;采用双抗体夹心ABC -ELISA法检测TPO、TGF -β1 水平 ;采用原位杂交法检测TGF -βRⅢ的表达情况。结果 　①AITP组与CITP组骨髓TPO的水平均高于对照组 ,且CITP组明显高于AITP组 (P <0 .0 5 ) ,但三组之间无显著差异 (P >0 .0 5 ) ;②AITP组与CITP组骨髓TGF -β1 的水平及巨核细胞TGF -βRⅢ的表达均明显高于对照组 (P <0 .0 5 ) ,且CITP组明显高于AITP组 (P <0 .0 5 ) ,三组之间有显著差异 (P <0 .0 5 ) ;③除CITP组骨髓TPO与TGF -β1 的水平呈正相关关系外 (r =0 .65 3 ,P <0 0 5 ) ,其余两组均无明显相关性 (P >0 .0 5 )。结论 　检测ITP患儿骨髓TPO、TGF -β1的水平及巨核细胞TGF -βRⅢ的表达情况对于研究ITP的发病机制以及早期分型和判断预后有重要参考价值。

The levels of thrombopoietin transforming growth factor-β1 and transforming growth factor-β1 receptorⅢ in bone marrow in children with ITP

Objective To study the cytokines and their receptor of regulating megakaryopoisis in children with idiopathic thrombocytopenic purpura (ITP). Methods Bone marrow were respectively aspirated from 28 children with AITP, 16 children with CITP and 20 comparably normal children; Percoll density gradient and immunomagnetic beads method were used to purify megakaryocytes from bone marrow; ABC-ELISA was used to detect TPO and TGF-β 1 in bone marrow; situ hybridization was used to detect TGF-β RⅢ on megakaryocyte. Results ① in AITP and CITP, the levels of TPO in bone marrow were both increased compared with controls, and there was significant difference between AITP and CITP (P<0.05), but there was not significant difference between the three groups (P>0.05); ② the levels of TGF-β 1 and TGF-β RⅢ had significant difference between the three groups (P<0.05); ③ in CITP, the levels of TP0 and TGF-β 1 were positively correlated (r=0.653, P<0.05), but in AITP and controls, there were no correlationships (P>0.05). Conclusions The results indicate that evaluation of the levels of TPO, TGF-β 1 and TGF-β RⅢ in bone marrow is of great value in the understanding of the pathogenesis and evaluating the differencial types of ITP in children.