CD40-CD40L在儿童持续性免疫性血小板减少症发病机制中的作用研究

目的：通过检测CD40-CD40L在持续性免疫性血小板减少症（Persistent ITP）患儿外周血单个核细胞中的表达情况，以揭示其在儿童持续性ITP发病机制中的作用。方法应用流式细胞术检测20例持续性ITP患儿治疗前后及20例对照组儿童外周血单个核细胞中CD40-CD40L的表达情况，用ELISA法检测血小板抗体（PAIgG）。结果与对照组比较，CD40和CD40L治疗前后的表达均增高（P＜0.01，P＜0.05）， CD40治疗前高于治疗后（P＜0.05），CD40L在两组的表达则差异无统计学意义（P＞0.05）；CD40、CD40L的表达与PAIgG均呈正相关（r分别为0.713、0.746，P＜0.05）。结论 CD40-CD40L共刺激信号异常可能为儿童持续性ITP发病机制之一，阻断此共刺激途径可能获得较好的治疗效果。

The Effect of CD40 and CD40L in pathogenesis of children with persistent immune thrombocytopenia

Objective To investigate the expression of CD40 and CD40L in peripheral blood mononuclear cells of patients with childhood Persistent immune thrombocytopenia（Persistent ITP）, and to explore their possible roles in the pathogenesis of the disease. Methods The positivity rates of CD40 and CD40L in peripheral blood mononuclear cells were measured by flow cytometry in 20 Persistent ITP patients （prior treatment and post treatment） and 20 normal controls. Platelet-associated antibody（PAIgG） were detected by enzyme linked immunosorbent assay （ELISA） technique. Results Compared with controls, the expression of CD40 and CD40L were higher in both prior treatment group and post treatment group（P〈0.01,P〈0.05）, Compared with post treatment group, the expression of CD40 in prior treatment group were higher（P〈0.05=. The expression of CD40 and CD40L had positive correlation with PAIgG （r=0.713, 0.746;P〈0.05）. Conclusion CD40 and CD40L pathway may play important roles in the pathogenesis of Persistent ITP, and it is possible to be a good therapeutic target if we can obstruct this way.