State Of The Immune Function Of Patients Of Immune Thrombocytopenia With The Syndrome Of Qi Failing To Control Blood And The Biological Basis Of Qi,Blood And Vein

ObjectiveTo research the relationship between immune cells,cytokines,transcription factors and qi deficiency,and to study biological nature of ITP.MethodsAccoreding to the Consenus of Chinese experts on diagnosis and treatment of adult primary immune thrombocytopenia(version 2012),forty patients were divided into three groups,New diagnostic group(NQ 9 patients),Persistent group(PG,9 patients)and Chronic group(CQ 22 patients).Then divid the patients into Mild group(MIG,8 patients),Moderate group(MOG,14 patients)and Severe group(SG,18 patients),according to Key specialty purpura of TCM blood disease(immune thrombocytopenic purpura)diagnosis and treatment plan.The Control group contains 20 healthy persons,which have passed physical examination in xi yuan hospital Extracting peripheral blood.The expressions of immune cells were detected by Flow cytometry,the expressions of cytokines were detected by AimPlex,the expressions of NO/NOS and ET-1 were detected by ELISA,the expressions of Transcription factors were detected by RT-PCR.Results1.Immune cellsCompared with control group,the expressions of Thl were increased significantly(P<0.05),the Th2 cells decreased significantly(P<0.05),the ratio of Thl/Th2 cells significantly increased(P<0.05),Treg,Th17 cells,Breg cells and ratio of Th17/Treg were decreased significantly(P<0.05)in experimental group,the incipient group,the new diagnosis group,chronic group,mild,moderate and severe groups of Thl cells increased significantly(P<0.05),the Th2 cells decreased significantly(P<0.05),the ratio of Thl/Th2 cells significantly increased(P<0.05),Treg and Th17 cells Breg cells and ratio of Th17/Treg were significantly decreased(P<0.05)in the NG,PG and CG.There were no differerces among the three groups.Th2 cells in the MOG and SG were significantly lower than those in the MIG,but the rest of the immune cells in the MOG,SG and MIG have no difference with each other.2.CytokinesCompared with control group,the expressions of IL-17A,IL-22 and TNF-awere increased significantly in ITP group while the expressions of IL-4,TGF-? and IL-10 in ITP group were significantly decreased.There were no significantly differences between the expressions of IL-6 in ITP group and in control group.Compared with control group,the expressions.of IL-17A,IL-22 and TNF-awere increased significantly in the MIG MOG,SG,NG,PG and CG(P<0.05)while the expressions of IL-4,TGF-? and IL-10 in MIG MOQ SG,NQ PG and CG(P<0.05)were significantly decreased.But there were no differences among NQ PG and CG.There were no no differences of the expressions of IL-6 among MIG MOG and SG.The expressions of IL-6 in CG was significantly higher than the expressions of IL-6 in NG.The expressions of IFN-y in MIG and SG were significantly higher than that in control group,but the here were no differences between that in MOG and in control group;The expressions of IL-17A in MOG and SG were significantly higher than that in MIG(P<0.05),and the expressions of IL-17A in SG were significantly higher than that in MOG;the expressions of TNF-a in SG were significantly higher than that in MIG and MOGThe expressions of TGF-? in MOG and SG were significantly lower than that in MIG(P<0.05);the expressions of TGF-? in SG were significantly lower than that in MOG(P<0.05).The other cytokines among those groups have no significantly differences.3.Transcription factorCompared with control group,the expressions of T-bet,GATA-3,ROR-y t and Foxp3 were increased significantly in NQ PG,CG,MIG,MOG and SG.There were no significantly differences of those transcription factors among NG,PG and CG There were no significantly differences of T-bet,ROR-? t and Foxp3 among MIG,MOG and SG.The expressions of GATA-3 in SG were significantly higher than that in MIG(P<0.05)and MOG(P<0.05).The expressions of GATA-3 in MOG were significantly higher than that in MIG(P<0.05).4.Vascular endothelial factorCompared with control group,the expressions of NO and ET-1 were significantly lower while the expressions of NOS,VEGF-A and VEGF-D were increased significantly in NG,PG,CG,MIG,MOG and SG But there were no significantly differences of those vascular endothelial factors among NG,PG,CG,MIG,MOG and SGConclusionThe nature of qi deficiency may was the imbalance of Proinflammatory factors and Suppression of inflammatory factors.The dysfunction of Thl,Th2,Thl/Th2,Th17,Treg,Th17/Treg,Breg,IL-17A,IL-22,TNF-?,IFN-?,IL-4,TGF-?,IL-10,T-bet,GATA-3,ROR-y t and Foxp3 were lead to qi deficiency.The process of qi failed to control blood and blood overflow pulse means process of proinflammatory damage the vascular endothelial,and the abnormal of expressions of ET-1,NO,NOS,VEGF-A and VEGF-D reflects the damage situation.