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目的:检测免疫性血小板减少症(ITP)患者中B细胞活化因子(BAFF)、BAFF受体(BAFF-R)及白细胞介素-21(IL-21)的表达,并进行相关性分析,进一步探讨其临床意义。方法:应用酶联免疫吸附试验(ELISA)法检测18例ITP患者和15例对照者血浆BAFF和IL-21的表达;应用流式细胞术检测CD19+细胞上BAFF-R的表达及CD3+CD8-IL-21+和CD3+CD8+IL-21+细胞的比例。结果:活动性ITP患者血浆BAFF和IL-21水平均明显高于对照者[(589.9±201.9)pg/ml∶(424.5±164.2)pg/ml,(156.8±112.0)pg/ml∶(82.0±27.0)pg/ml,均P<0.05]。CD19+细胞均表达BAFF-R,且ITP患者中BAFF-R表达明显低于对照者[(45.1±10.4)∶(71.2±18.8),P<0.01]。发现IL-21表达于CD3+CD8-细胞和CD3+CD8+细胞上,ITP患者中CD3+CD8-IL-21+细胞亚群比例、CD3+CD8+IL-21+细胞亚群比例均显著高于对照者[(4.3±1.0)%∶(2.9±1.4)%,(1.0±0.6)%∶(0.6±0.3)%,均P<0.05]。血浆BAFF与IL-21存在正相关(P<0.01),BAFF-R与IL-21存在负相关(P<0.05)。结论:ITP患者中BAFF、IL-21表达均升高,且两者血浆水平之间存在正相关,BAFF-R与IL-21存在负相关,提示BAFF/BAFF-R信号通路与IL-21在ITP的发病中发挥重要作用。
Objective: To detect the expression of BAFF, BAFF-R and IL-21 in patients with immune thrombocytopenia (ITP) Explore its clinical significance. Methods: The plasma levels of BAFF and IL-21 in 18 patients with ITP and 15 controls were detected by enzyme linked immunosorbent assay (ELISA). The expressions of BAFF-R and CD3 + CD8 + on CD19 + cells were detected by flow cytometry IL-21 + and CD3 + CD8 + IL-21 + cells. Results: The levels of plasma BAFF and IL-21 in patients with active ITP were significantly higher than those in controls [(589.9 ± 201.9) pg / ml: (424.5 ± 164.2) pg / ml, (156.8 ± 112.0) pg / ml:82.0 ± 27.0) pg / ml, all P <0.05]. BAFF-R was expressed in CD19 + cells, and the expression of BAFF-R in ITP patients was significantly lower than that in controls [(45.1 ± 10.4) vs (71.2 ± 18.8), P <0.01]. It was found that IL-21 was expressed on CD3 + CD8- and CD3 + CD8 + cells. The percentage of CD3 + CD8-IL-21 + cells and CD3 + CD8 + IL-21 + cells in ITP patients were significantly higher than those in ITP patients Control subjects (4.3 ± 1.0)%: (2.9 ± 1.4)%, (1.0 ± 0.6)%: (0.6 ± 0.3)%, all P <0.05]. There was a positive correlation between plasma BAFF and IL-21 (P <0.01), but negative correlation between BAFF-R and IL-21 (P <0.05). CONCLUSIONS: The expression of BAFF and IL-21 in ITP patients is elevated, and there is a positive correlation between plasma levels of BAFF-R and IL-21, suggesting that there is a negative correlation between BAFF / BAFF-R signaling pathway and IL-21 ITP plays an important role in the pathogenesis.