Objective: To investigate the significance of Th17/Treg imbalance in the development and treatment of primary immune thrombocytopenia (ITP) in children.
Methods: Thirty-two children diagnosed with ITP between May and August, 2015 and 22 healthy children were enrolled. Flow cytometry was used to determine the Th17/Treg ratio in peripheral blood of healthy children and children with ITP before and after treatment with immunoglobulin.
Results: Compared with the patients with ITP before treatment, the healthy children and the patients treated with immunoglobulin had a significantly lower percentage of Th17 cells in CD4+ T cells, a significantly lower Th17/Treg ratio, and a significantly higher percentage of Treg cells in CD4+ T cells in peripheral blood (P<0.05). In the 32 ITP children treated with immunoglobulin, 20 had complete response, 4 had response, and 8 had no response. The patients with complete response had a significantly lower percentage of Th17 cells in CD4+ T cells and a significantly lower Th17/Treg ratio in peripheral blood than the patients without response (P<0.05).
Conclusions: The Th17/Treg imbalance can be found in children with ITP. Immunoglobulin can improve the cellular immune function by regulation of the Th17/Treg ratio. The Th17/Treg ratio may serve as an indicator for assessing the therapeutic effects of ITP.
目的: 探讨Th17/Treg细胞比例失衡在儿童原发性免疫性血小板减少症(ITP)发病及治疗中的意义。
方法: 选取2015年5月至2015年8月确诊为ITP的32例患儿作为ITP组, 同期选取22例健康儿童作为健康对照组, 采用流式细胞术分别检测初诊ITP患儿、丙种球蛋白治疗后的ITP患儿和健康对照组儿童外周血Th17、Treg细胞的比例。
结果: ITP患儿治疗前外周血Th17占CD4+T细胞的比例、Th17/Treg细胞比值均显著高于治疗后及健康对照组儿童(P＜0.05), 治疗前Treg细胞占CD4+T细胞的比例显著低于治疗后及健康对照组儿童(P＜0.05);32例ITP患儿经治疗后, 20例完全反应, 4例有效, 8例无效, 完全反应患儿外周血Th17细胞占CD4+T细胞比例、Th17/Treg细胞比值显著低于无效患儿(P＜0.05)。
结论: 儿童ITP中存在Th17/Treg细胞比例失衡, 丙种球蛋白可通过调节Th17/Treg细胞比例变化进而改变患儿细胞免疫功能, 治疗过程中检测该比值变化可能对疾病的疗效有一定的预测作用。