The Study Of Glucocorticoid Receptors In Adult Idiopathic Thrombocytopenic Purpura

Objective: To evaluate the expression of glucocorticoid receptors(GR)in peripheral blood lymphocytes and to make a forecast of the value with glucocorticoid in adult patients with idiopathic thrombocytopenic purpura(ITP).Methods: The study included 30 patients with ITP. The expressions of serum hydrocortisone were detected by Electrocheminescence immunoassay when patients were prior therapy and the expressions of membranelas-sociated glucocorticoid receptor (mGR)and intracellalar glucocorticoid (iGR) in peripheral blood lymphocytes were detected by flow cytometry when patients were prior-treatment and post-treatment.Result: There was no significant difference of serum hydrocortisone expression between acute and chronic ITP adult patients (P>0.05) and between glucocorticoid sensitive and counteract ITP adult patients(P>0.05).The expressions of both mGR and iGR were higher in patients with ITP than in normal control(P<0.05).There was no significant difference of mGR expression between acute and chronic ITP patients and between GC sensitive and counteract ITP adult patients P>0.05),while the iGR level was no significant difference between acute and chronic ITP patients(P>0.05) and was significantly higher in GC sensitive ITP adult patients than those of GC counteract (P<0.05). The expressions of iGR were higher in GC sensitive ITP adult patients who were post-treatment than those who were prior-treatment (P<0.05).The expressions of iGR were lower in GC counteract adult patients who were post-treatment than those who were prior-treatment(P<0.05).Conclusion: The differences of Serum hydrocortisone expression between the ITP patients and the normal control are not obvious. The level of mGR and iGR rises in either acute ITP or chronic ITP patients. The level of iGR is related to the effect of GC therapy, and it could be used as a reference marker for the evaluation of therapeutic effect in adult patients with ITP.