Effects of Recombinant Human Thrombopoietin on Funtion of T and B Lymphocyte in Prieary ITP Patients / 中国实验血液学杂志

OBJECTIVE@#To study the changes of Th1 and Th2 type cytokines and B lymphocyte level and their clinical significance in idiopathic thrombocytopenic purpura (ITP) patients treated by recombinant human thrombopoietin (rhTPO).@*METHODS@#The peripheral blood levels of Th1 and Th2 type of cytokines and B lymphocyte were estimated by CBA in 48 patients with ITP, and compared with those in 35 control persons of heath examination.@*RESULTS@#Before treatment, the levels of Th1 type cytokines and B lymphocyte in 48 patients with ITP were higher, and the levels of Th2 type cytokines were lower than those of healthy controls (P＜0.05). The levels of the peripheral blood CD19 cells, CD5CD19 cells, IL-2 expression negatively correlated with Plt counts in ITP patients (P＜0.05), the levels of IL-4 positively correlated with Plt counts (P＜0.05). After treatment with rhTPO, the levels of Th1 type cytokines and B lymphocytes in 48 patients with ITP significantly decreased, and the levels of Th2 type cytokines significantly increased in comparison with those before treatment (P＜0.05).@*CONCLUSION@#Peripheral blood Th1 and Th2 type cytokines express abnormally and level of B lymphocytes increases significantly in ITP patinets. The disease severity correlats with the levels of Th1 and Th2 type cytokines and B lymphocytes. Platelets increase after rhTPO treatment, showing that rhTPO can play an important role in regulating Th1 and Th2 immunologic balance and B lymphocyte level in ITP patients.

Clinical Significance of the Balanceshift of Th1 and Th2 Type Cytokines in Patients with Primary Immune Thrombocytopenic Purpura Detected by Cytometric Bead Array / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the levels of Th1/Th2 cytokines in peripheral blood of patients with primary immune thrombocytopenic purpura(ITP) before and after treatment and their clinical significance.</p><p><b>METHODS</b>Ninety-eight cases of ITP were treated with glucocorticoid(GC), then were divided into 2 groups: effectively treated group and uneffectively treated group according to efficacy of treatment, 40 healthy persons confirmed by health examination were selected and enrolled in control group. The levels of Th1 cytokines(IFN-γ,TNFα,IL-2) and Th2 cytokines(IL-4,IL-5,IL-10) were detected by cytometric bead array before and at 4 weeks, 3 and 6 months after treatment and the relationship among detected indexes was analyzed.</p><p><b>RESULTS</b>Before treatment with glucocorticoid, the levels of Th1 type cytokines were in 98 patients with ITP were higher and the levels of Th2 type cytokines were lower, compared with the healthy controls(P<0.05). The IL-2/IL-4 ratio was significantly higher than that of healthy controls(P<0.05). After treatment, the levels of Th1 type cytokines in effectively treated group were significantly decreased and the levels of Th2 type cytokines were significantly increased, compared with level before treatment(P<0.05). The IL-2/IL-4 ratio was significantly decreased after treatment for 6 months, compared with that before treatment(1.05±0.43 vs 2.53±0.72)(P<0.05), but the level of Th1 or Th2 type cytokines did not obviously changed.</p><p><b>CONCLUSION</b>Peripheral blood Th1 and Th2 cells express abnormally in ITP patients, ITP is a Th1 dominated disease; the change of IL-2/IL-4 ratio before and after treatment correlated with the prognosis of ITP patients, displaying clinical significance for ITP individual therapy.</p>

Fas-FasL and caspase-3 signal transduction pathway and apoptosis of peripheral T lymphocytes in ITP patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the relationship between Fas-FasL-mediated signal transduction pathway and apoptosis of T lymphocyte subset in ITP patients.</p><p><b>METHODS</b>The expression rates of membrane Fas, FasL and intracellular activated caspase-3 in peripheral T lymphocyte subset were determined by flow cytometry. T cell subsets with caspase-3 protein expression were detected by Western blot.</p><p><b>RESULTS</b>As compared with that in healthy control group [(29.4 +/- 8.2)%], the expression rate of membrane Fas on CD4+ T cells was significantly increased in ITP patients [(42.1 +/- 9.5)%] (P < 0.05), however, that on CD8+ T cells was only slightly increased [(9.3 +/- 6.0)% vs (13.4 +/- 5.8)%] with no statistical significance (P > 0.05). The expression rate of FasL on T cell subset in ITP patients was significantly increased (P < 0.05), and that of intracellular activated caspase-3 in T cell subset in ITP patients was notably higher than that in healthy control group (P < 0.05). Western blot analysis showed that the expression of pro-caspase-3 and cleaved-caspase-3 in CD4+ T cells in patients with ITP after treatment were significantly reduced compared with those before treatment (P < 0.05).</p><p><b>CONCLUSION</b>Apoptosis of T lymphocyte subset in ITP patients is accelerated. It is possible that Fas-FasL signal transduction pathway plays an important role in the induction of the apoptosis. The degree of apoptosis of T lymphocytes closely correlates with the disease's activity in ITP patients. Hormone therapy may interfere with Fas-FasL signal transduction pathway of apoptosis.</p>