Objectives: To investigate the expression of interleukin-37 (IL-37), vascular endothelial growth factor A (VEGFA), and transforming growth factor-β1 (TGF-β1) in children with primary immune thrombocytopenia (ITP) and their correlation with T cells.
Methods: A retrospective analysis was conducted on 45 children with ITP (ITP group) who were admitted to Handan Central Hospital from January 2020 to April 2022, and 30 healthy children who underwent physical examination during the same period were included as the healthy control group. The mRNA expression levels of IL-37, VEGFA, and TGF-β1 and the levels of regulatory T cells (Treg) and helper T cells 17 (Th17) were measured before and after treatment, and the correlation between the mRNA expression levels of IL-37, VEGFA, and TGF-β1 and the levels of Treg, Th17, and Treg/Th17 ratio were analyzed.
Results: Compared with the healthy control group, the ITP group had a significantly higher mRNA expression level of IL-37 and a significantly higher level of Th17 before and after treatment, as well as significantly lower mRNA expression levels of VEGFA and TGF-β1 and significantly lower levels of Treg and Treg/Th17 ratio (P<0.05). After treatment, the ITP group had significant reductions in the mRNA expression level of IL-37 and the level of Th17 and significant increases in the mRNA expression levels of VEGFA and TGF-β1 and the levels of Treg and Treg/Th17 ratio (P<0.05). Correlation analysis showed that in the ITP group, the mRNA expression levels of IL-37 and TGF-β1 were negatively correlated with the levels of Treg and Treg/Th17 ratio (P<0.05) and were positively correlated with the level of Th17 (P<0.05) before and after treatment; the mRNA expression level of VEGFA was positively correlated with the levels of Treg and Treg/Th17 ratio (P<0.05) and was negatively correlated with the Th17 level (P<0.05) before and after treatment.
Conclusions: Abnormal expression levels of IL-37, VEGFA, and TGF-β1 may be observed in children with ITP, which is significantly associated with the imbalance of Treg/Th17 ratio. It is speculated that the cytokines such as IL-37, VEGFA, and TGF-β1 may be involved in the development and progression of ITP or may become important potential targets for the treatment of children with ITP. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(11): 1131-1136.
目的: 探讨白细胞介素-37（interleukin-37, IL-37）、血管内皮生长因子A（vascular endothelial growth factor, VEGFA）、转化生长因子-β1（transforming growth factor-β1, TGF-β1）在儿童原发免疫性血小板减少症（primary immune thrombocytopenia, ITP）患儿中的表达及其与T细胞的相关性。方法: 回顾性选取河北省邯郸市中心医院于2020年1月—2022年4月收治的45例ITP患儿为ITP组，选取30例同期健康体检儿童为健康对照组。测定并比较ITP组患儿治疗前后及健康对照组儿童的IL-37、VEGFA、TGF-β1 mRNA水平，以及调节性T细胞（regulatoryT cell, Treg）和辅助性T细胞17（helper T cell 17, Th17）的水平差异，分析IL-37、VEGFA、TGF-β1 mRNA水平与Treg、Th17及Treg/Th17的相关性。结果: ITP组患儿治疗前后IL-37 mRNA及Th17水平高于健康对照组，VEGFA、TGF-β1 mRNA及Treg、Treg/Th17水平低于健康对照组（P<0.05）；且与治疗前比较，治疗后ITP组患儿IL-37 mRNA、Th17水平下降，VEGFA、TGF-β1 mRNA及Treg、Treg/Th17水平上升（P<0.05）。相关性分析结果显示，ITP组患儿治疗前后IL-37 mRNA、TGF-β1 mRNA水平与Treg、Treg/Th17呈显著负相关（P<0.05），与Th17呈显著正相关（P<0.05）；治疗前后VEGFA mRNA水平与Treg、Treg/Th17呈显著正相关（P<0.05），与Th17呈显著负相关（P<0.05）。结论: IL-37、VEGFA、TGF-β1在儿童ITP中存在异常表达，且与Treg/Th17比例失衡有明显关系，推测IL-37、VEGFA、TGF-β1等细胞因子可能参与疾病的发生与发展，或可成为治疗儿童ITP的重要潜在靶点。 ［中国当代儿科杂志，2023，25（11）：1131-1136］.
Keywords: Child; Interleukin-37; Primary immune thrombocytopenia; T cell; Transforming growth factor-β1; Vascular endothelial growth factor A.