特发性血小板减少性紫癜患者外周血淋巴细胞协同刺激分子的表达

目的　探讨T、B淋巴细胞表面协同刺激分子在特发性血小板减少性紫癜 (ITP)的变化。方法　用流式细胞术检测 2 1例ITP患者和 9名正常人外周血淋巴细胞协同刺激分子B7 CD2 8和CD4 0 表达率 ,用ELISA方法检测ITP患者外周血PAIgG的含量。结果　ITP患者外周血CD4+ CD2 8+ 细胞率明显低于正常对照 ,CD86+ 、CD1 9+ CD86+ /CD1 9+ 细胞率明显高于对照组 (P <0 .0 5 ) ,而CD2 8+ 、CD4 0+ 、CD80+ 、CD1 9+ CD80+ 、CD1 9+ CD86+ 、CD1 9+ CD4 0+ 、CD4+ CD2 8+ /CD4+ 、CD1 9+ CD80+ /CD1 9+ 、CD1 9+ CD4 0+ /CD1 9+ 细胞率与对照组相比差异无显著性。 2 1例ITP患者中 16例PAIgG的含量高于正常 ,平均值为(184 .6 2± 38.0 0 )ng 10 7血小板 ,且PAIgG的含量与CD1 9+ CD86+ /CD1 9+ 细胞率呈正相关。结论　ITP患者CD4+ T淋巴细胞表面的协同刺激分子CD2 8表达无缺陷。PAIgG与B淋巴细胞表面的协同刺激分子CD86 的改变明显相关 ,因此CD86 的改变可能参与ITP自身免疫的病理机制 ,并为ITP患者单克隆抗体治疗提供理论指导。

Expression of costimulatory molecules on peripheral blood lymphocytes of patients with idiopathic thrombocytopenic purpura

OBJECTIVE: To investigate the expressions of costimulators on peripheral T and B lymphocytes in patients with idiopathic thrombocytopenic purpura (ITP). METHODS: The expression of B7-CD(28) and CD(40) of peripheral lymphocytes was measured by flow cytometry in 21 ITP patients and 9 normal subjects. The expression of PAIgG was measured by ELISA method. RESULTS: The expression of CD(4)(+)CD(28)(+) was lower in ITP patients than in normal controls, but the expression of CD(86)(+) and CD(86)(+)CD(19)(+) was higher in ITP patients than in normal controls, while the expression of CD(80)(+), CD(40)(+), CD(28)(+), CD(19)(+)CD(86)(+), CD(19)(+)CD(40)(+), CD(4)(+)CD(28)(+)/CD(4)(+), CD(19)(+)CD(80)(+)/CD(19)(+) and CD(19)(+)CD(40)(+)/CD(19)(+) in ITP patients was normal. The PAIgG level was higher in 16 patients with a mean of (184.62 +/- 38.00) ng/10(7) plt. A positive correlation was found between PAIgG and CD(19)(+)CD(86)(+)/CD(19)(+) expression. CONCLUSION: There is no deficiency in expression of CD(28) on CD(4)(+) T lymphocytes in ITP patients. The change of CD(86) expression on B lymphocytes is possibly involved in pathophysiology of ITP, which may provide a theoretical instruction for ITP patients immunological therapy.