Expression And Significance Of CD4~+CD25~+CD127~- Regulation T Cell And Its Related Cytokines In Acute And Chronic ITP Children

Objective:To detect the proportion of CD4~+CD25~+CD127~-regulation T cell、transforming growth factor β1、interleukin 10 in children peripheral blood in acute primary immune thrombocytopenia AITP and chronic primary immunethrombocytopenia,and to explore their roles in the mechanism in ITP.Methods:Selected 66 cases of ITP children according to the ITP diagonstic standards who received treatment inpatient and outpatient in hematology department of Kindcare Childrenˊs Hospital of Shanxi from January 2015 to June 2016.Divided the primary immune thrombocytopenia children into AITP and CITP according to the course of the disease,AITP group included 35 cases who visited a doctor the first time and not received the treatment about human immune globulin and glucocorticoid,CITP group included 31 cases who were sick longer than 12 months.Divided the AITP children into serious ITP group of 11 cases and not serious ITP group of 24 cases according to the illness severity.Control group included 20 children who were healthy children took a physical examination in medical center in Kindcare Childrenˊs Hospital of Shanxi.The proportion of CD4~+CD25~+CD127~-regulation T cell and the content of IL-10 were detected by flow cytometry in peripheral blood in AITP group、CITP group、serious ITP group、not serious ITP group and healthy children in control group.Analyzed the content of TGF-β1 by ELISA.To compare the proportion of CD4~+CD25~+CD127~-regulation T cell and their related cytokines in those groups and to analyze the relationships between them.Results:1.Quantitative tests showed:the proportion of CD4~+CD25~+CD127~-Treg in AITP group(4.23±0.82)% was significantly lower than which in CITP group(5.05±0.90)%(P<0.01);the proportion of CD4~+CD25~+CD127~-Treg in CITP group(3.47±0.63)% was significantly lower than which in AITP group(4.23±0.82)%(P<0.01).The amount of TGF-β1 in AITP group(189.36±66.71)Pg?ml-1 was significantly lower than which in control group(231.45±113.89)Pg?ml-1(P<0.05),The amount of IL-10 in AITP group(34.07±11.57)Pg?ml-1 was significantly lower than which in control group(43.83±10.96)Pg?ml-1(P<0.05),the amount of TGF-β1 and IL-10 in CITP group were significantly lower than which in AITP group(P<0.01).The proportion of CD4~+CD25~+CD127~-Treg in not serious ITP group(4.55±0.90)% was significantly higher than which in serious ITP group(4.14±0.58)%(P<0.05),the amount of TGF-β1 in not serious ITP group(210.25±73.65)Pg?ml-1 was not significantly higher than which in serious ITP group(188.16±57.7)Pg?ml-1(P>0.05),The amount of IL-10 in not serious ITP group(39.42±13.55)Pg?ml-1 was not significantly higher than which in serious ITP group(31.63±9.9)Pg?ml-1(P>0.05).2.Correlation analysis showed: there were positive correlations between proportion of CD4~+CD25~+CD127~-regulation T cell and TGF-β1 in peripheral blood in ITP children(r=0.75,P<0.01).The content of IL-10 had no correlation with proportion of CD4~+CD25~+CD127~-regulation T cell and TGF-β1 in peripheral blood in ITP children.Conclusion:The decrease of CD4~+CD25~+CD127~-regulation T cell、TGF-β1 and IL-10 in peripheral blood in ITP may be connected with cellular immumune regulation function disorder of ITP children,the change of immune function related with regulation T cell is particularly obvious in CITP group and serious ITP group,it is maybe one of the reason why CITP and serious ITP children not be good therapeutic effect and the longer course of the disease.