Objective: To investigate the proportion of regulatory T cells(Treg cells) in peripheral blood and the expression of programmed death receptor-1 (PD-1) on Treg cells in adult primary immune thrombocytopenia(ITP) patients, and to analyze their clinical significance. Methods: Altogether 30 patients with ITP were enrolled and divided into effective group(21 patients)and ineffective group(9 patients)according to whether platelets returned to normal level after treatment. Flow cytometry(FCM) was applied to determine the counts of CD3+ T lymphocytes, and proportions of Treg cells and PD-1+ Tregcells in ITP patients pre- and post-treatment. Results: The count of CD3+ T lymphocytes was not differed significantly before and after treatment in both the effective treatment group [6.39±5.74)×109/L vs (5.49±4.86)×109/L] and ineffective group[(8.34±2.95)×109/L vs (7.87±1.47)×109/L]. The proportion of Treg cells increased from 16.96%±4.61% to 32.74%±9.38% in effective treatment group(P<0.05), and the proportion of PD-1+ Treg cells increased from 14.88%±6.75% to 29.62%±7.97%(P<0.05). In contrast, Treg cells increased a little and maintained at a low level in ineffective group (from 17.41%±6.77% to 19.18%±7.64%, P>0.05) and PD-1+ Treg had no significant increase (from 15.30%±6.57% to 19.58%±6.91%, P>0.05). Moreover, the proportions of peripheral blood Treg cells and PD-1+ Treg cells in the effective group were significantly higher than those in the ineffective group after treatment (P<0.05). Conclusions: Treg cells and PD-1+ Treg cells may play an important role in the development and progress of ITP. The detection of proportion of these two cells in peripheral blood might be helpful to predict the prognosis of ITP.
LI Tan, LI Bin, LIU Yuanyuan, BAO Yangyi
. Expression of PD-1 on peripheral blood Treg cells in patients with primary immune thrombocytopenia[J]. Journal of Diagnostics Concepts & Practice, 2018
, 17(03)
: 294
-298
.
DOI: 10.16150/j.1671-2870.2018.03.012
[1] Vanikar AV, Trivedi HL.T-Regulatory Cells: The Recently Recognized Players of Immunomodulation[J]. J Stem Cell Res Therapy, 2014,4(10):1000241
[2] Araki K, Youngblood B, Ahmed R.Programmed cell death 1-directed immunotherapy for enhancing T-cell function[J]. Cold Spring Harb Symp Quant Biol,2013,78:239-247.
[3] Francisco LM, Salinas VH, Brown KE, et al.PD-L1 regulates the development, maintenance, and function of induced regulatory T cells[J]. J Exp Med,2009,206(13):3015-3029.
[4] 牛倩, 黄卓春, 蔡蓓, 等. CD4~+ CD25~(high) Treg和CD4~+ CD25~(low) T细胞及PD-1分子在SLE和RA患者外周血中的表达分析[J]. 细胞与分子免疫学杂志,2011,27(1):23-25.
[5] 中华医学会血液学分会止血与血栓学组. 成人原发免疫性血小板减少症诊断与治疗中国专家共识(2016年版)[J]. 中华血液学杂志,2016,37(2):89-93.
[6] Feng Q, Xu M, Yu YY, et al.High-dose dexamethasone or all-trans-retinoic acid restores the balance of macrophages towards M2 in immune thrombocytopenia[J]. J Thromb Haemost,2017,15(9):1845-1858.
[7] Lo E, Deane S.Diagnosis and classification of immune-mediated thrombocytopenia[J]. Autoimmun Rev,2014,13(4-5):577-583.
[8] Rosenblum MD, Way SS, Abbas AK.Regulatory T cell memory[J]. Nat Rev Immunol,2016,16(2):90-101.
[9] Vitales-Noyola M, Doníz-Padilla L, álvarez-Quiroga C, et al.Quantitative and functional analysis of CD69(+) NKG2D(+) T regulatory cells in healthy subjects[J]. Hum Immunol,2015,76(7):511-518.
[10] Stasi R, Cooper N, Del Poeta G, G, et al. Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab[J]. Blood,2008,112(4):1147-1150.
[11] Ling Y, Cao X, Yu Z, et al.Circulating dendritic cells subsets and CD4+Foxp3+ regulatory T cells in adult patients with chronic ITP before and after treatment with high-dose dexamethasome[J]. Eur J Haematol,2007,79(4):310-316.
[12] Bao W, Bussel JB, Heck S, et al.Improved regulatory T-cell activity in patients with chronic immune thrombocytopenia treated with thrombopoietic agents[J]. Blood,2010,116(22):4639-4645.
[13] Zhang XL, Peng J, Sun JZ, et al.De novo induction of platelet-specific CD4(+)CD25(+) regulatory T cells from CD4(+)CD25(-) cells in patients with idiopathic thrombocytopenic purpura[J]. Blood,2009,113(11):2568-2577.
[14] Semple JW.Thrombopoietin can induce tolerogenic responses via the modulation of thymic and splenic T lymphocyte populations in a murine model of immune thrombocytopenia (ITP)[C]. 54th Annual Meeting of the American Society of Hematology,Atlanta,2012.
[15] Franceschini D, Paroli M, Francavilla V, et al.PD-L1 negatively regulates CD4+CD25+Foxp3+ Tregs by limiting STAT-5 phosphorylation in patients chronically infected with HCV[J]. J Clin Invest,2009,119(3):551-564.