The Clinical Significance And Study Of Regulatory B Cells In Immune Thrombocytopenia

Objective: To explore clinical significance of Regulatory B cells(Bregs)in the patients with ITP.And to explore the roles of Bregs on occurrence,development,bleeding risk,outcome and prognosis in ITP and deeply elucidate the roles of Bregs in the pathogenesis of ITP.Methods: There were 124 patients with ITP in the outpatient department or department of Hematology in Affiliated Hospital of Jining Medical University(Jining,China)were admitted in as experimental group and 37 cases of healthy people as control group.All 124 cases were diagnosed according to the diagnostic criteria of ITP.The ITP patients were all from January 2015 to December 2016.According to the clinical typing and staging of ITP,the experimental group was divided into different subgroups: Newly diagnosed ITP group,Persistent ITP group,Severe ITP group,Chronic ITP group and CR group.The flow cytometry was used to detect the percentage of CD19+CD24hi CD38 hi Bregs and its functional parameter IL-10 of such subjects in the peripheral blood samples and compared the levels of CD19+CD24hi CD38 hi Bregs and IL-10 in the ITP subgroups and healthy control group.Then,according to Bleeding score of ITP,we gave a score to these ITP patients.And we selected platelet counts,age,disease phases and Bleeding score as parameters to detect the correlations with Bregs and IL-10 by correlationanalysis.Results: Compared to controls,the percentage of CD19+CD24hiCD38hi Bregs in patients with ITP was significantly decreased(2.7519%±1.71625%,p<0.05),and its functional parameter IL-10 was also decreased(2.5059% ± 1.55297,p<0.05).In addition,among the different subgroup of ITP,the percentage of CD19+CD24hiCD38hi Bregs and its functional parameter IL-10 in the Persistent ITP group,Severe ITP group and Chronic ITP group was less than other subgroups(p<0.05).However,in CR ITP group,the percentage of CD19+CD24hiCD38hi Bregs and its functional parameter IL-10 was significantly increased.What's more,further investigation was performed by multi-factor analysis.Selceting platelet counts,age,disease phases and Bleeding score as parameters,we found that Bregs was positively correlated with platelet counts in peripheral blood(r=0.829,p<0.05)and the severity of ITP(r=0.434,p<0.05),but negatively correlated with Bleeding score of ITP(r=-0.771,p<0.05).And its functional parameter IL-10 was positively correlated with platelet counts in peripheral blood(r=0.742,p<0.05)and the severity of ITP(r=0.358,p<0.05),but negatively correlated with Bleeding score of ITP(r=-0.668,p<0.05).Conclusion: Bregs may participate in and play an important role in the occurrence,development,bleeding risk,outcome and prognosis ofITP.And Bregs can be regarded as a new target for the immune therapy of ITP.