Study Of The Correlation Between Treg,Th17Cells And Immune Thrombocytopenic Purpura

Objective:In this study,we detected the frequencies of regulatory T cell(CD4+CD25+Foxp3+Treg) and Thl7(IL-17A+) cells of peripheral blood momonuclear cell (PBMC) in immune thrombocytopenic purpura (ITP) patients before and after three different therapies with glucocorticoid (GC), intravenous immunoglobulin (IVIG), splenectomy or normal control by intracellular cytokine staining and flow cytometric analysis, explore the difference between ITP and normal control and influence in Treg and Thl7cells of ITP patients with this three therapies, and the correlation of platelet count and Treg,Thl7cells in ITP patients before and after treatments.Methods:31cases of ITP patients as inpatients and outpatients of the Second Xiangya Hospital of Central South University from September2011to February2012,according to different treatment methods were divided into three groups,GC,IVIG,splenectomy. Platelet counted between2～30×109/L in27cases without splenectomy,25～142×109/L in4cases with splenectomy.Normal control group was from the outpatient medical examination of healthy volunteers,the platelet counted in157～306×109/L. CD4+CD25+Foxp3+Treg/CD4+(%) and Th17(IL-17A+)/CD4+(%) were analyzed by Flow cytometric analysis in PBMC from patients or healthy donors.Results:(1) ITP patients before treatments and normal control GD4+CD25+Foxp3+Treg/CD4+cells(%) compared to (2.26±0.75vs5.36±1.58) was significantly decreased, p<0.05, with statistical significance. GC,IVIG two groups before and after treatment compared to (4.38±1.46vs2.32±0.79,4.67±1.45vs2.01±0.50) was significantly increased, p<0.05, with statistical significance. Splenectomy with ITP without treatment compared to (4.37±0.73vs2.26±0.75) was significantly increased, p<0.05, with statistical significance. Three groups after treatment with normal control group pairwise comparisons was no significant difference.(2) ITP patients before treatments and normal control Th17(IL-17A+)/CD4+cells(%) compared to (2.58±0.55vs1.17±0.50) was significantly increased,p<0.05, with statistical significance. GC,IVIG, splenectomy two groups before and after treatment compared to (2.01±0.55vs1.30±0.49,2.66±0.65vs1.43±0.57) was significantly increased,p<0.05, with statistical significance. Splenectomy with ITP without treatment compared to (2.58±0.55vs1.37±0.27) was significantly increased, p<0.05, with statistical significance. Three groups after treatment with normal control group pairwise comparisons no significant difference.(3) ITP patients before-after treatment platelet count(×109/L) difference with Treg/CD4+(%) difference compared to a positive correlation, p<0.05, with statistical significance.Conclusions:(1) CD4+CD25+Foxp3+Treg/CD4+cells(%) decrease in ITP patients,on the contrary, Th17(IL-17A+) cells increase in them,the result suggest that Treg cells reduce and Th17cells increase involve in the pathogensis of ITP.(2)Treg cells increased and Th17cells dereased in ITP with three different treatments suggest that upragulation Treg and downragulation Thl7in peripheral blood of ITP patients may be one of the common mechanisms of the three methods of treatments.(3) ITP before-after treatment platelet count (×109/L) difference with Treg/CD4+(%) difference is a positive correlation.