Breg Tfh Tfr细胞在免疫性血小板减少症患者中的表达及意义

目的 探讨调节性B细胞（Breg）、滤泡辅助性T细胞（Tfh）、滤泡调节性T细胞（Tfr）在免疫性血小板减少症（ITP）中的作用和临床意义。方法 选择2017年10月至2019年10月安徽医科大学第一附属医院收治的初次诊断的30例ITP患者为ITP组，同期选择健康对照组25例，应用流式细胞术（FCM）检测外周血Breg、Tfh、Tfr细胞的表达水平并统计分析。结果 ITP组患者外周血CD19⁺B细胞中Breg（1.93±1.21）%]、IL-10⁺Breg（28.64±10.31）%]水平低于健康对照组，差异有统计学意义（P<0.05）；外周血CD4⁺T细胞中Tfh细胞比例高于健康对照组（12.18±5.26）% vs（6.21±1.78）%]，Tfr细胞比例（1.64±1.01）%]、Tfr/Tfh比值（0.21±0.13）低于健康对照组，差异均有统计学意义（P<0.05）。结论 Breg细胞降低，IL-10分泌减少，Tfr/Tfh比值失衡，在ITP发病过程中可能起到重要的作用。

Expression and significance of Breg Tfh Tfr cells in immune thrombocytopenia

Objective To investigate the role of regulatory B cells (Breg), follicular helper T cells (Tfh) and follicular regulatory T cells (Tfr) in the pathogenesis of immune thrombocytopenia (ITP).Methods The present study recruited 30 newly diagnosed ITP patients and 25 healthy controls in the Department of Hematology of the First Affiliated Hospital of Anhui Medical University from October 2017 to October 2019. Flow cytometry (FCM) was used to assess the expression levels of Breg, Tfh and Tfr cells in the peripheral blood.Results The proportions of Breg cells(1.93±1.21)%] and IL-10⁺ Breg cells(28.64±10.31)%] in CD19⁺ B cells of newly diagnosed ITP patients were significantly lower than those in the healthy control group (P<0.05). The proportion of Tfh cells in CD4⁺ T cells of the newly diagnosed ITP patients was higher than that of healthy controls(12.18±5.26)% vs (6.21±1.78)%],with Tfr cells(1.64±1.01)%] and Tfr/Tfh ratio (0.21±0.13)both lower than those of healthy controls. The differences were statistically significant (P<0.05).Conclusion Reduced proportion of Breg cells, decreased secretion of IL-10 and imbalanced Tfr/Tfh ratio may play an important role in the pathogenesis of ITP.