| Primary immune thrombocytopenia(ITP)is the most common hemorrhagic clinical disease.ITP is an acquired hemorrhagic disease characterized by accelerated platelet clearance due to platelet autoantibodies.The cause of the disease is the production of platelet autoantibodies,increased platelet destruction,and poor platelet production,leading to thrombocytopenia.Clinical features of ITP are increased bleeding or bleeding tendency.MDSC,a myeloid-derived immunoregulatory cell,proliferate significantly during tumor,inflammation,and infection.In recent years,a large number of studies have confirmed that MDSC is involved in the pathogenesis of various autoimmune diseases.Therefore,this study hopes to explore the possible participation mechanism of MDSC in ITP.Objective:1.To detect the number of MDSCs in bone marrow of adult ITP patients;2.To detect cytokines IFN-? in the bone marrow of adult ITP patients;3.To detect the PGE2 content in bone marrow serum of adult ITP patients;4.To discuss MDSCs,IFN-?,PGE2 participate in the possible mechanism of ITP.Methods:A total of 50 inpatients from the Department of Hematology,General Hospital of Tianjin Medical University from January 2017 to October 2017 were selected.Twenty-five patients with ITP were initially treated.Twenty-five patients with ITP were complete remission groups.15 cases as healthy control group.Flow cytometry(FCM)was used to analyze the differences in the number of MDSCs in the three groups of bone marrow.The RT-qPCR technique was used to analyze the differences in the relative expression of IFN-? mRNA in bone marrow mononuclear cells of three groups.The PGE2 levels in the bone marrow serum of three groups were analyzed by ELISA.Results:The number of MDSC in the complete remission group of adult ITP patients was higher than that of the control group,the difference was significantly different(3600 ± 803.6 vs.932.7 ± 542.2,P < 0.05).The number of MDSC in the untreated group was higher than that of the control group(1882 ± 725.6 vs.932.7 ± 542.2,P=0.34).The total MDSC in the complete remission group was higher than that of the untreated group(3600±803.6 vs.1882 ± 725.6,P=0.49).The number of G-MDSCs in the complete remission group was higher than that in the control group(1636±293.4 vs.406.5±66.5).The number of G-MDSC in the untreated group was higher than that in the control group(1157±140.6 vs.406.5±66.5).The number of G-MDSC in the complete remission group was higher than that of the initial treatment group(1636±293.4 vs.1157±140.6).The relative content of IFN-gamma in bone marrow mononuclear cells of ITP patients in the untreated group was higher than that in the control group and the complete remission group(P<0.001).The quantitative value of IFN-gamma gene in bone marrow mononuclear cells of the first treatment group and the complete remission group was 2.60.The content of PGE2 in bone marrow serum of untreated group was higher than that of the control group,the difference was statistically significant(169.8 ± 6.98 vs.130.8 ± 11.25,P<0.05).The content of PGE2 in the complete remission group was higher than that in the control group(200.9 ± 16.90 vs.130.8 ± 11.25,P<0.05).The PGE2 content in the bone marrow serum of the untreated group was lower than that of the complete remission group.The difference was statistically significant in the total remission group(169.8 ± 6.98 vs.200.9 ± 16.90,P < 0.01).Conclusion:1.The number of MDSCs and G-MDSC subpopulations of ITP patients in the complete remission group were higher than those in the untreated group.2.The levels of IFN-? in the bone marrow of adult ITP patients increased at the time of onset,and the IFN-? content in the bone marrow of the untreated group was higher than that of the control and complete remission groups.3.The level of PGE2 in bone marrow serum was increased in the adult ITP patients.The PGE2 content in the untreated group was higher than that in the control group.4.There was a positive correlation between the number of MDSCs and the number of platelets(treatment response).5.There was a positive correlation between the number of MDSCs and PGE2 content in bone marrow.6.MDSC has potential value in the treatment of ITP. |
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