| 摘要: |
| 目的 探讨Treg/Th17 失衡在免疫性血小板减少症(ITP)中医"血热妄行"、"阴虚火旺"、"气不摄血"证型中的作用及意义。 方法 ITP患者92例,按中医证型分为血热妄行组30例、阴虚火旺组31例、气不摄血组31例;健康志愿者30例。采集外周血,采用流式细胞术(FCM)检测Th17 细胞和Treg 细胞的数量,RT-PCR检测Foxp3和ROR-γt mRNA水平,比较各组间上述指标的差异。 结果 3组不同证型的ITP患者外周血Treg细胞数量均低于正常对照组(P<0.05),且血热妄行组低于气不摄血组和阴虚火旺组(P<0.05),气不摄血组低于阴虚火旺组(P<0.05)。3组不同证型 ITP患者外周血Th17细胞数量高于正常对照组(P<0.05),且血热妄行组高于气不摄血组及阴虚火旺组(P<0.05)。3组Treg/Th17与对照组相比均降低(P<0.05),血热妄行组低于气不摄血组和阴虚火旺组(P<0.05),气不摄血组低于阴虚火旺组(P<0.05)。3组不同证型的ITP患者Foxp3 mRNA水平均低于正常对照组(P<0.05),且各组间两两比较差异有统计学意义(P<0.05)。3组不同证型的ITP患者ROR-γt mRNA水平高于正常对照组(P<0.01)。 结论 ITP患者中Treg 细胞数量减少参与了ITP的发生和发展,Treg/Th17比例失衡在ITP的发病机制中可能有重要作用。Treg细胞数量、Treg/Th17比例、Foxp3 mRNA水平在ITP 各证型间的分布规律为血热妄行组< 气不摄血组< 阴虚火旺组。 |
| 关键词: 免疫性血小板减少症 调节性T淋巴细胞 Th17细胞 辨证分型 |
| DOI：10.3724/SP.J.1008.2015.1254 |
| 投稿时间：2015-03-06修订日期：2015-04-28 |
| 基金项目:上海市卫生局科研课题(20114035),全国黄振翘名老中医传承工作室项目,上海市卫生局中药新药及院内制剂研发项目(20112J018),上海市科委中药现代化专项(10DZ1974100,11DZ1971600),上海市卫生局青年科研项目(20124Y017). |
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| Correlation between Treg/Th17 and Traditonal Chinese Medicine syndrome differentiation classification in patients with immune thrombocytopenia |
| ZHENG Xue-qian,ZHOU Shao-hong*,TU Ren-feng,CHEN Ying-kun,HU Ming-hui,HU Ling-yan |
(Department of Hemantology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
*Corresponding author.) |
| Abstract: |
| Objective To explore the role of Treg/Th17 cell ratio imbalance in the pathogenesis of idiopathic thrombocytopenic purpura (ITP) patients with different Traditional Chinese Medicine (TCM) syndrome differentiation classifications: bleeding due to blood-heat, Yin deficiency with fire hyperactivity and Qi deficiency-caused bleeding. Methods A total of 92 patients were divided into the bleeding due to blood-heat group (n=30), Yin deficiency with fire hyperactivity group (n=31) and Qi deficiency-caused bleeding group (n=31) according to the TCM syndrome differentiation classification. The peripheral blood samples were obtained from the patients and 30 volunteers served as healthy controls. The percentages of Treg cells and Th17 cells in the blood samples were analyzed by flow cytometry, and the mRNA levels of Foxp3 and ROR-γt were analyzed by RT-PCR. Results The percentages of Treg cells in the peripheral blood of 3 different TCM syndrome ITP groups were significantly lower than those of control group (P<0.05), that of the bleeding due to blood-heat group was significantly lower than that of Yin deficiency with fire hyperactivity group and Qi deficiency-caused bleeding group (P<0.05), and that of Qi deficiency-caused bleeding group was signficantly lower than that of Yin deficiency with fire hyperactivity group (P<0.05). The percentages of Th17 cells in peripheral blood of 3 different TCM syndrome ITP groups were significantly higher than that of control group(P<0.05), and that of Yin deficiency with fire hyperactivity group was signficanlty higher than that of Qi deficiency-caused bleeding group (P<0.05). The ratios of Treg/Th17 of the 3 different TCM syndrome ITP groups were significantly lower than that of control group (P<0.05), that of the bleeding due to blood-heat group was significantly lower than that of Qi deficiency-caused bleeding group and Yin deficiency with fire hyperactivity group (P<0.05), and that of Qi deficiency-caused bleeding group was significantly lower than that of Yin deficiency with fire hyperactivity group (P<0.05). The Foxp3 mRNA levels of 3 different TCM syndrome ITP groups were significantly lower than that of control group (P<0.05), and there were significant differences between each two groups by the pairwise comparison (P<0.05). While ROR-γ mRNA levels of the 3 different TCM syndrome ITP groups were significantly higher than that of the control group (P<0.01). Conclusion The decreased Treg cells in patients with ITP contributes to the development and progression of ITP. The imbalance of Treg/Th17 ratio may play a critical role in the pathogenesis of ITP. The distribution of the percentages of Treg cells, the ratio of Treg/Th17 and the mRNA level of Foxp3 in a increasing order is: bleeding due to blood-heat group < Qi deficiency-caused bleeding group < Yin deficiency with fire hyperactivity group. |
| Key words: immune thrombocytopenia regulatory T-lymphocytes Th17 cells syndrome differentiation classification |
