ABSTRACT
Objective@#To explore the effect of high mobility group box-1 protein (HMGB1) on the balance of Th17/Treg in patients with immune thrombocytopenia (ITP).@*Methods@#A total of 30 patients who were first diagnosed as ITP in the Fifth People's Hospital of Datong from July 2017 to April 2018 were selected as the case group, and another 30 healthy volunteers in the corresponding period were taken as the control group. The proportion of Th17 and Treg cells was detected by using flow cytometry, and the concentration of HMGB1, interleukin (IL)-17 and transforming growth factor β (TGF-β) in plasma was tested by using enzyme-linked immunosorbent assay (ELISA). Isolated peripheral blood mononuclear cells (PBMC) were cultured in vitro. After the treatment with recombinant human HMGB1 (rhHMGB1), real-time polymerase chain reaction (RT-PCR) was applied to detect the mRNA expression changes in Treg cell transcription factor intracellular forkhead helix transcription factor 3 (Foxp3) and Th17 cell transcription factor retinoid related orphan receptor γt (RORγt). The differences of indicators in Treg cell transcription factor peripheral blood between the case group and the control group were compared, and the balance correlation between HMGB1 and Th17/Treg was analyzed.@*Results@#Compared with the healthy control group, the proportion of Th17 cells and the expression level of HMGB1 and IL-17 in peripheral blood of ITP patients were increased (all P < 0.01), while the proportion of Treg cells and the level of TGF-β were decreased (all P < 0.01). The proportion of Th17 cells and the expression level of IL-17 and HMGB1 in peripheral blood of ITP patients were positively correlated with the concentration of HMGB1 (all P < 0.01); the proportion of Treg cells and the level of TGF-β were negatively correlated with the expression level of HMGB1 (all P < 0.01). In vitro experiments, the expression of intracellular RORγt mRNA was increased compared with the negative control group (1.50±0.24 vs. 0.93±0.22, t = 9.612, P < 0.01), and the expression of Foxp3 mRNA was decreased compared with the negative control group after the stimulation of PBMC by rhHMGB1 (0.72±0.19 vs. 1.08±0.18, t = 7.387, P < 0.01).@*Conclusion@#The high level of HMGB1 in the peripheral blood of ITP patients induces Th17/Treg imbalance and aggravates inflammatory reactions, which may be an important cause of ITP.
ABSTRACT
Objective:To explore the effect of high mobility group box-1 protein (HMGB1) on the balance of Th17/Treg in patients with immune thrombocytopenia (ITP).Methods:A total of 30 patients who were first diagnosed as ITP in the Fifth People's Hospital of Datong from July 2017 to April 2018 were selected as the case group, and another 30 healthy volunteers in the corresponding period were taken as the control group. The proportion of Th17 and Treg cells was detected by using flow cytometry, and the concentration of HMGB1, interleukin (IL)-17 and transforming growth factor β (TGF-β) in plasma was tested by using enzyme-linked immunosorbent assay (ELISA). Isolated peripheral blood mononuclear cells (PBMC) were cultured in vitro. After the treatment with recombinant human HMGB1 (rhHMGB1), real-time polymerase chain reaction (RT-PCR) was applied to detect the mRNA expression changes in Treg cell transcription factor intracellular forkhead helix transcription factor 3 (Foxp3) and Th17 cell transcription factor retinoid related orphan receptor γt (RORγt). The differences of indicators in Treg cell transcription factor peripheral blood between the case group and the control group were compared, and the balance correlation between HMGB1 and Th17/Treg was analyzed.Results:Compared with the healthy control group, the proportion of Th17 cells and the expression level of HMGB1 and IL-17 in peripheral blood of ITP patients were increased (all P < 0.01), while the proportion of Treg cells and the level of TGF-β were decreased (all P < 0.01). The proportion of Th17 cells and the expression level of IL-17 and HMGB1 in peripheral blood of ITP patients were positively correlated with the concentration of HMGB1 (all P < 0.01); the proportion of Treg cells and the level of TGF-β were negatively correlated with the expression level of HMGB1 (all P < 0.01). In vitro experiments, the expression of intracellular RORγt mRNA was increased compared with the negative control group (1.50±0.24 vs. 0.93±0.22, t = 9.612, P < 0.01), and the expression of Foxp3 mRNA was decreased compared with the negative control group after the stimulation of PBMC by rhHMGB1 (0.72±0.19 vs. 1.08±0.18, t = 7.387, P < 0.01). Conclusion:The high level of HMGB1 in the peripheral blood of ITP patients induces Th17/Treg imbalance and aggravates inflammatory reactions, which may be an important cause of ITP.
ABSTRACT
Objective To compare the efficacy and adverse reaction of rituximab injection( Rituximab) and splenectomy in the treatment of adult chronic idiopathic thrombocytopenic purpura ( ITP). Methods From March 2013 to June 2015,105 chronic ITP patients who were treated in the Fifth People＇s Hospital of Datong were divided into rituximab group(n=43) and splenectomy group( n =62).The clinical efficacy,adverse reaction and survival time of the two groups were compared.Results There was no statistically significant difference in baseline character-istics between the two groups. After treatment for 3 months, the response rates of the splenectomy group and the rituximab group were 91. 9%( 57/62 ), 69. 8%( 30/43 ), respectively, the difference was statistically significant between the two groups(χ2 =5.04,P=0.005).After treatment for 12 months,the response rates of the splenectomy group and the rituximab group were 88.7%(55/62),58.1%(25/43),respectively,the difference was statistically significant between the two groups ( χ2 =6. 83, P =0. 001 ), respectively. After treatment for 3,12 months, the complete response rates of the splenectomy group were 82.2%(51/62),80.6%(50/62),respectively,which were higher than those of the rituximab group [39.5%(17/43),34.9%(15/43)] (χ2 =7.25,P＜0.001).There was no statistically significant difference in adverse reactions after treatment for 1 year between the two groups(P>0.05). The survival time of the splenectomy group was longer,but there was no statistically significant difference( t=4.85, P=0.18).Conclusion The curative effect of splenectomy in the treatment of adult ITP is better than rituximab,and the adverse reaction is not obvious between two methods.
ABSTRACT
Objective@#To compare the efficacy and adverse reaction of rituximab injection(Rituximab) and splenectomy in the treatment of adult chronic idiopathic thrombocytopenic purpura(ITP).@*Methods@#From March 2013 to June 2015, 105 chronic ITP patients who were treated in the Fifth People's Hospital of Datong were divided into rituximab group(n=43) and splenectomy group(n=62). The clinical efficacy, adverse reaction and survival time of the two groups were compared.@*Results@#There was no statistically significant difference in baseline characteristics between the two groups.After treatment for 3 months, the response rates of the splenectomy group and the rituximab group were 91.9%(57/62), 69.8%(30/43), respectively, the difference was statistically significant between the two groups(χ2=5.04, P=0.005). After treatment for 12 months, the response rates of the splenectomy group and the rituximab group were 88.7%(55/62), 58.1%(25/43), respectively, the difference was statistically significant between the two groups (χ2=6.83, P=0.001), respectively.After treatment for 3, 12 months, the complete response rates of the splenectomy group were 82.2%(51/62), 80.6%(50/62), respectively, which were higher than those of the rituximab group [39.5%(17/43), 34.9%(15/43)] (χ2=7.25, P<0.001). There was no statistically significant difference in adverse reactions after treatment for 1 year between the two groups(P>0.05). The survival time of the splenectomy group was longer, but there was no statistically significant difference(t=4.85, P=0.18).@*Conclusion@#The curative effect of splenectomy in the treatment of adult ITP is better than rituximab, and the adverse reaction is not obvious between two methods.