摘要
目的：探讨 CD4＋ T 淋巴细胞亚群及相应转录因子和上游转录调节因子在过敏性紫癜（HSP）病理机制中的调控作用。方法采用流式细胞术（FCM）、酶联免疫吸附法（ ELISA）、荧光定量聚合酶链反应（RT-PCR）测定41例 HSP 急性期患儿（急性期组）、35例 HSP 临床缓解期患儿（缓解组）和30例健康儿童（健康对照组）外周血单个核细胞（PBMC）中辅助性 T 淋巴细胞（Th）1、Th2、调节性 T 淋巴细胞（Treg）、Th17细胞百分比，血浆干扰素-γ（IFN-γ）、白细胞介素（IL）-4、转化生长因子-β1（TGF-β1）、IL-17水平和 PBMC 中 T 淋巴细胞 T-box（ T-bet）、GATA 结合蛋白-3（ GATA3）、插状头/翅膀状螺旋转录因子-3（ Foxp3）和孤核受体γ（ROR-γt）mRNA 表达。结果1. HSP 急性期组、缓解组患儿 PBMC 中 Th1、Treg 细胞百分比，相应血浆 IFN-γ、TGF-β1水平，T-bet、Foxp3 mRNA 表达均低于健康对照组（P 均﹤0.05），Th2、Th17细胞百分比，血浆 IL-4、IL-17水平和 GATA3、ROR-γt mRNA 表达均高于健康对照组（P 均﹤0.05），Th1/ Th2和 Treg/ Th17失衡；2. HSP 缓解组患儿 PBMC 中 Th1、Th2、Th17、Treg 和 Treg/ Th17与急性期组比较差异均无统计学意义（ P 均﹥0.05）， Th1/ Th2、TGF-β1及相应 T-bet mRNA、Foxp3 mRNA 高于急性期组（P 均﹤0.05），IL-4、IL-17及相应 GATA3、ROR-γt mRNA 均低于急性期组（P 均﹤0.05），Th1/ Th2和 Treg/ Th17仍存在失衡；3. Th1、Th2、Treg、Th17百分数分别与 IFN-γ、IL-4、TGF-β1、IL-17，T-bet、GATA3、Foxp3和 ROR-γt mRNA 表达均呈正相关（ P 均﹤0.05）。结论 HSP 存在 Th1/ Th2、Treg/ Th17免疫失衡，Treg 诱导的免疫耐受被打破，并贯穿整个病理过程。
Objective To explore the alternations of CD4 ＋ T cell subsets and their cytokines and transcription factors in children with Henoch - Schonlein purpura（HSP）. Methods Forty - one children were enrolled in this stud-y,including 41 in acute stage of HSP,35 cases of HSP in clinical remission stage and 30 healthy children as healthy control group. The percentages of helper T lymphocytes（Th）1,Th2,regulatory T cells（Treg）and Th17 subsets were determined by flow cytometry（FCM）. The concentrations of plasma interferon - γ（ INF - γ）,interleukin（ IL） - 4, transforming growth factor - β1（TGF - β1 ）and IL - 17 were examined by ways of enzyme - linked immunosorbent assay（ELISA）. The expressions of T - bet,GATA3,Foxp3 and ROR - γt mRNA in peripheral blood mononuclear cells were examined by means of reverse transcription - polymerase chain reaction（RT - PCR）. Results （1）During the a-cute and recovery stage of HSP,compared with the control group,the percentages of Th2 and Th17 cell subsets,the le-vels of plasma IL - 4 and IL - 17,and the expressions of GATA3 and ROR - γt mRNA were significantly higher（all P ﹤ 0. 05）. The percentages of Th1 and Treg cell subsets,the levels of plasma INF - γ and TGF - β1 and the expres-sions of T - bet and Foxp3 mRNA were lower（all P ﹤ 0. 05）. The imbalances of Th1 / Th2 and Treg/ Th17 appeared during the acute stage of HSP.（2）During the recovery stage of HSP,the percentages of Th1,Th2,Th17 and Treg,and the ratio of Treg / Th17 were of no difference compared with those in acute stage（ all P ﹥ 0. 05）. The ratio of Th1 / Th2,and the expressions of T - bet and Foxp3 mRNA were increased（all P ﹤ 0. 05）,while the levels of plasma IL - 4 and IL - 17,the expressions of GATA3 and ROR - γt mRNA were decreased（all P ﹤ 0. 05）compared with those in acute stage. In the recovery stage of HSP,the imbalances of Th1 / Th2 and Treg/ Th17 were still obvious .（3）There was a positive correlation in every 2 cytokines of Th1,INF - γ and T - bet. And the same correlation existed in Th2, IL - 4 and GATA3,in Treg,TGF - β1 and Foxp3,and in Th17,IL - 17 and ROR - γt（P ﹤ 0. 05）. Conclusions The imbalance of Th1 / Th2 and Treg/ Th17 is critical in pathological mechanism of HSP. The disturbance of immune tole-rance induced by Treg cells is important in HSP.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2015年第21期1614-1618,共5页
Chinese Journal of Applied Clinical Pediatrics
基金
基金项目：河北省科学技术研究与发展计划项目（13277763D）
