The Study On Relationship Between The Expression Of MiRNA181a-5p And The Imbalance Of Treg/Th17 In Primary Immune Thrombocytopenia

Background:Primary immune thrombocytopenia(ITP)is an acquired autoimmune hemorrhagic disease,which is characterized by accelerated platelet destruction and insufficient platelet production mediated by immune dysfunctions.In recent years,with our understanding of this disease,it has been found that the imbalance of Treg/Th17 is closely related to the incidence of ITP,but the mechanism of its occurrence remains unresolved.Our study confirmed that the expression of miRNA181a-5p was significantly reduced in the peripheral circulation of ITP patients,and may be involved in the pathogenesis of ITP.Therefore,it is particularly important to further explore the involvement of miRNA181a-5p in immune imbalance of Th17 subsets and Treg cells in ITP patients.Objective:We aimed to investigate the role of the relationship between the expression of miRNA181a-5p and the imbalance of Treg/Th17 in the pathogenesis of ITP.By detecting the expression level of mi RNA181A-5p,the frequency of Treg cell and Th17 subsets in the untreated group and the effectively treated group in ITP patients,comparing with the healthy control group,and analyzing the correlation between the expression of miRNA181a-5p,the imbalance of Treg/Th17 and clinical characteristics in ITP group,which contributes to clarify the mechanism of T cell immune imbalance in ITP patients.Methods:1.Peripheral blood was collected from 37 ITP patients,concluding 21 untreated patients and 16 effectively treated patients in the Second Hospital of Jilin University,and 19 healthy controls were enrolled in the study.2.Peripheral blood mononuclear cells(PBMCs)were isolated and the expression of miRNA181a-5p and Notch1 was analyzed by RT-PCR.3.The frequency of Th17 subsets and Treg cells in the peripheral circulation of each sample was detected by Flow cytometer(FCM).4.The expression level of miRNA181a-5p,the expression level of Notch1,the frequency of Th17 subsets,the frequency of Treg cells and the Treg/ Th17 ratio were analyzed among the ITP group,the effectively treated group and the healthy control group.5.The correlation between the expression of miR-181a-5p and the expression of Notch1,the frequency of Treg cells,the frequency of Th17 subsets and Treg/Th17 ratio in ITP group was analyzed.Clinical data of ITP group was collected,including age,platelet count and disease course,to analyze the correlation between the expression of miR-181a-5p and clinical characteristics of ITP patients.Results:1.The expression of miR-181a-5p was significantly decreased in ITP group than that of control group.After effective treatment,the expression of miR-181a-5p was significantly higher than that of ITP group,but still significantly lower than that of control group.2.The expression of Notch1 was significantly increased in ITP group and effectively treated group than that of control group,while there was no significant difference between the ITP group and effectively treated group.3.There was no significant difference in the frequency of Treg cells in the ITP group,the effectively treated group and the control group.The frequency of Th17 subsets in ITP group was significantly increased than that of control group,while the proportion of Treg/Th17 was significantly decreased.4.There was a positive correlation between the expression of miR-181a-5p and the proportion of Treg/Th17 in ITP group.However,the expression of miR-181a-5p was not correlated with the expression of Notch1,the frequency of Treg cells and Th17 subsets.In addition,the expression of miR-181a-5p was not correlated with the clinical characteristics of patients,including age,disease course and platelet count.Conclusions:1.The expression of miR-181a-5p is significantly decreased in ITP patients,and is closely related to Treg/Th17 imbalance,suggesting that the decreased expression of miR-181a-5p may be involved in regulating the mechanism of Treg/Th17 immune imbalance in ITP patients.2.The expression of Notch1 is significantly increased in ITP patients,while the expression of miR-181a-5p and Notch1 still failed to reach the level of healthy subject after effective treatment,which may be related to the failure of current treatment measures to maintain long-term effectiveness.3.The expression of miR-181a-5p can be significantly corrected in ITP patients after effective treatment,suggesting that the expression of miR-181a-5p may be related to the treatment response of ITP patients,and can be used to predict the treatment effectiveness of ITP patients.