调节性B细胞在免疫性血小板减少症发病过程中的意义

本研究旨在探讨调节B细胞（Breg）在免疫性血小板减少症（ITP）发病中的作用及其临床意义。采用流式细胞术检测35例已确诊的ITP患者及20例正常对照的CD19＋CD24hi CD38hi B细胞的表达率，应用RT—PCR检测患者IL-10mRNA、TGF-β1mRNA细胞因子的表达水平。结果表明，初诊ITP患者外周血CD19＋ CD24hi CD38hi B细胞的表达率明显低于正常对照组，差异有统计学意义（P〈0．05）；治疗后血小板数升高的ITP患者的CD19＋ CD24hi CD38hi B细胞的表达率高于治疗前的ITP患者，且差异有统计学意义（P〈0．05）；初诊ITP患者IL-10mRNA的表达明显低于正常对照组（P〈0．05），治疗后的ITP患者IL-10mRNA的表达明显升高，且与治疗前相比差异有统计学意义（P〈0．05）；初诊ITP患者TGF-β1mRNA的表达高于正常对照组（P〈0．05），ITP患者经治疗后TGF—β1mRNA的表达下降，且差异均有统计学意义（P〈0．05）。结论：Breg细胞通过体液免疫及对T淋巴细胞的调节在ITP发病机制中可能有重要作用。

Significance of Regulatory B cells in Nosogenesis of Immune Thrombocytopenia

This study was aimed to investigate the role of regulatory B cells （Breg） in pathogenesis of immune thrombocytopenia（ITP） and its clinical significance. A total of 35 ITP patients and 20 normal controls were enrolled in this study. The expression of CD19 ＋ CD24hiCD38hi B cells was detected by flow cytometry and the expression of IL-10 mRNA and TGF-β1 mRNA was assayed by RT-PCR. The results indicated that the expression level of CD19＋ CD24hi CD38hi B cells in peripheral blood of newly diagnosed ITP patients was obviously lower than that in normal controls （P 〈0.05 ） ; the expression level of CD19 ＋ CD24hiCD38hi B cells in ITP patients with increased pletelet count after treat- ment was higher than that before treatment （ P 〈 0.05 ） ; the expression level of IL-10 mRNA in newly diagnosed ITP pa- tients was significantly lower than that the in normal controls（ P 〈 0.05 ）, the expression level of TGF-β1 mRNA in new- ly diagnosed ITP patients increases as compared with normal controls（ P 〈 0.05 ）, after treatment with DXM the expres- sion of IL-10 mRNA was enhanced, the expression of TGF-β1 mRNA was reduced as compared with expression level before treatment （ P 〈 0.05 ）. It is concluded that the Breg cells may play an important role in the pathogenesis of ITP via humoral immunity and its regulation of T lymphocytes.