免疫性血小板减少症患者外周血中microRNA-181a、microRNA-146a、microRNA-326及microRNA-142-3p的表达

目的 通过检测4种免疫相关的microRNAs （miR-181a、miR-146a、miR-326和miR-142-3p）在免疫性血小板减少症（ITP）患者外周血单个核细胞（PBMCs）中的表达，探讨miRNA在ITP中的作用及意义。方法 采用实时定量PCR（RT-PCR）法，检测34例ITP患者（ITP组）及31例健康人（正常对照组）外周血PBMCs中4种miRNAs的表达水平；改良MAIPA法检测ITP组中22例患者抗血小板自身抗体GPIIb/IIIa、GPIb/IX，分析miRNA与抗血小板自身抗体的关系，以及与血小板计数等临床指标的相关性。结果 ITP组PBMCs中miR-146a、miR-326和miR-142-3p表达水平与正常对照组相比明显降低（P<0.05），miR-146a与miR-326 (r=0.437, P=0.011），miR-146a与miR-181a (r=0.652, P<0.001)，miR-326与miR-181a(r=0.745, P<0.001）的表达水平均呈显著正相关，且miR-146a与ITP患者血小板计数呈正相关（r=0.468，P=0.016）。ITP组不同性别间4种miRNAs表达水平差异无统计学意义（P>0.05）。ITP组中26例患者接受糖皮质激素治疗后，有效组与无效组4种miRNAs表达水平差异无统计学意义（P>0.05）。GPIb/IX、GPIIb/IIIa单阳性组、双阳性组和双阴性组间miRNAs的表达水平均无显著性差异（P>0.05）。结论 miR-146a、miR-326及miR-142-3p表达异常在ITP的发生和发展中可能发挥了一定的作用。

The aberrant expression of microRNA-181a,microRNA-146a,microRNA-326 and microRNA-142-3p in peripheral blood of patients with immune thrombocytopenia

Objective To investigate the expression profile of four immune-related microRNAs (miR-181a, miR-146a, miR-326 and miR-142-3p) in peripheral blood mononuclear cell (PBMCs) of patients with immune thrombocytopenia (ITP), and explore the role and significance of miRNAs in ITP patients. Methods The relative expression of the four miRNAs in the PBMCs was detected by real time polymerase chain reaction (RT-PCR) in 34 ITP patients (ITP group) and 31 healthy controls (control group). Modified MAIPA was used to detect platelet GPIIb/IIIa and GPIb/IX specific autoantibodies in 22 ITP patients. And the correlations of miRNAs expression with antiplatelet antibody, peripheral platelet count and clinical indexes were analyzed. Results The expression levels of miR-146, miR-326 and miR-142-3p in the PBMCs of ITP group were decreased significantly compared to those in control group (P<0.05) . The expression level of miR-146a was positively correlated with miR-326, miR-181a and the peripheral platelet counts (P<0.05). The expression level of miR-326 was positively correlated with the expression of miR-181a (P<0.05). The expression levels of the 4 miRNAs had no significant difference among sexes, effect of corticosteroid and different antibodies. Conclusion The abnormal expression of miR-146a, miR-326 and miR-142-3p may play a role in the occurrence and development of ITP.