| Objective To investigate the expression of CD4+CD25+CD127-/low regulatory T(Tegulatory T,Treg)cells and transforming growth factor-?1(TGF-?1)in peripheral blood of the different degree patients with ITP,and to detect the change of CD4+CD25+CD127-/lowTreg cells and TGF-?1i after treatment.To explore the significance and pathogenesis of CD4+CD25+CD127-/lowTreg cells and TGF-?1 in ITP,and their relationship with the severity of the disease,which probably provide a new immunological treatment for ITP.Methods Peripheral blood was selected from 112 cases patients with ITP before treatment and 20 cases normal controls in our Hospital from September 2016 to February 2018,then the number of CD4+CD25+CD127-/lowTreg cells was detected by the flow cytometry;the level of TGF-?1 was determined by Enzyme-linked immunosorbent assay.112 patients were divided into 2 groups according to the platelet count,one was observation group(30×109/L?platelets<100×109/L),the other was treatment group(platelets<30×109/L).The patients in mild group had no bleeding symptoms and did not need hormones and other treatment.The patients in treatment group need hormones or other treatment.The platelets in the healthy control group were?100×109/L,and the patients in this group had no bleeding symptoms.The 47 patients in treatment group were followed up in our hospital.The expression level of CD4+CD25+CD127-/lowTreg cells and TGF-?1 was detected by extracting peripheral blood before and(28±1)days after treatment.Results 1.Before treatment:The proportion of CD4+CD25+CD127-/lowTregs in peripheral blood of patients in observation group were(3.33± 1.07)%,and that in treatment group(2.21±0.45)%,were all lower than those in control group(6.20±1.32)%,P<0.05,The proportion of CD4+CD25+CD127-/lowTreg cells in observation group were higher than those in treatment group(P<0.05).The concentration of TGF-?1 in peripheral blood of patients in observation group were(0.89±0.25)ng/ml,and that in treatment group(0.54±0.06)ng/ml,were all lower than those in control group(2.04±0.83)ng/ml,P<0.05.The concentration of TGF-?1 in observation group were higher than those in treatment group(P<0.05).2.After treatment:The proportion of CD4+CD25+CD127-/low Treg cells in effective group were higher than that in inactive group[(4.83 ± 1.11)%vs(2.25±0.53)%,P<0.05].But the two groups were still lower than the healthy control group,P<0.05.The concentration of TGF-?1 in effective group were higher than that in inactive group[(1.63±0.57)ng/ml vs(0.69±0.15)ng/ml,P<0.05],but they were still lower than the healthy control group(P<0.05).3.Comparison before and after treatment:After treatment,the proportion of CD4+CD25+CD127-/lowTreg cells in the effective group(4.85±1.11)%were higher than before treatment(2.23±0.84)%,P<0.05,and there were no significant difference in the ineffective group after treatment(P=0.694).In the effective group,the concentration of TGF-?1 were higher than that before treatment both in the effective group and ineffective group[(1.63±0.57)ng/ml vs(0.54±0.06)ng/ml,(0.69±0.15)ng/ml vs(0.56±0.05)ng/ml](P<0.05).4.Correlative analysis of CD4+CD25+CD127-/lowTreg cells with platelets:Before treatment,the proportion of CD4+CD25+CD127-/low Treg cells were positively correlated with platelets(R=0.59,P<0.05).After treatment,the more obvious the increase of platelets,the higher the proportion of CD4+CD25+CD127-/lowTreg cells,they were positively correlated with platelets(R=0.47,P<0.05).5.Correlative analysis of TGF-?1 with platelets:Before treatment,the concentration of TGF-?1 were positively correlated with platelets(R=0.62,P<0.05).After treatment,the more obvious the increase of platelets,the higher the concentration of TGF-?1,they were positively correlated with platelets(R=0.50,P<0.05).6.Correlative analysis of CD4+CD25+CD127-/low Treg cells with TGF-?1:The proportion of CD4+CD25+CD127-/lowTreg cells were positively correlated with the concentration of TGF-?1 before treatment(R=0.35,P<0.05).After treatment,the proportion of CD4+CD25+CD127-/lowTreg cells and TGF-?1 concentration were higher than before,and they were positively correlated(R=0.50,P<0.05).Conclusion 1.The expression of CD4+CD25+CD127-/lowTreg cells and TGF-?1 in ITP patients were lower than that in healthy control group,indicating that the abnormal expression of CD4+CD25+CD127-/low Treg cells and TGF-?1 may be related to the pathogenesis of ITP.2.The level of CD4+CD25+CD127-/low Treg cells and TGF-?1 were related to the severity of the disease and the curative effect.It is suggested that increasing the number of CD4+CD25+CD127-/lowTreg cells or increasing the secretion of cytokine TGF-?1 can improve the immune balance of ITP patients and provide new ideas for clinical treatment. |
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