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血小板表面TLR2和TLR4在儿童特发性血小板减少性紫癜中的变化及意义
王春美, 盛光耀, 邹湘, 白松婷, 王璐
中国当代儿科杂志 ›› 2009, Vol. 11 ›› Issue (10) : 797-801.
PDF(942 KB)
PDF(942 KB)
血小板表面TLR2和TLR4在儿童特发性血小板减少性紫癜中的变化及意义
Levels of Toll-like receptors-2,-4 on platelets in children with idiopathic thrombocytopenic purpura
目的：探讨血小板表面Toll样受体TLR2和TLR4、淋巴细胞表面CD86和血清中IL-2，IFN-γ，IL-4，IL-10表达的变化及相关性在儿童特发性血小板减少性紫癜（ITP）发病中的意义。方法：流式细胞学技术检测24例急性特发性血小板减少性紫癜(AITP)患儿、21例慢性特发性血小板减少性紫癜（CITP）患儿和20例对照组儿童血小板表面TLR2和TLR4，CD86的表达水平；ABC-ELISA法检测血清中IL-2，IL-4，IL-10和IFN-γ的浓度。结果：①AITP组、CITP组患儿CD41+TLR2+和CD61+TLR4+表达显著低于对照组(P<0.01)；且AITP组显著低于CITP组（P<0.01)；②AITP组和CITP组CD86+表达较对照组显著增高（P<0.01），AITP组和CITP组间差异无显著性；③AITP组和CITP组血清IL-2，IL-4，IL-10及IFN-γ浓度均较对照组显著增高（P＜0.05），AITP组和CITP组间差异无显著性。④相关性分析：CD41+TLR2+表达与CD61+TLR4+表达呈正相关，二者均与CD86+表达及血清IL-2，IL-4，IL-10浓度呈负相关，与血清IFN-γ浓度无相关性。结论：联合检测血小板表面TLR2和TLR4、淋巴细胞表面CD86的表达和血清中IL-2，IFN-γ，IL-4，IL-10含量的变化及相关性对于研究儿童ITP的发病机制以及早期分型具有重要参考价值。［中国当代儿科杂志，2009，11（10）：797-801］
OBJECTIVE: To study the changes and significance of Toll-like receptor-2 (TLR2) and Toll-like receptor-4 (TLR4) on platelets, CD86 on lymphocytes and concentrations of IL-2, IFN-γ, IL-4 and IL-10 in serum in children with idiopathic thrombocytopenic purpura (ITP). METHODS: Peripheral blood samples were collected from 24 children with acute idiopathic thrombocytopenic purpura (AITP), 21 children with chronic idiopathic thrombocytopenic purpura (CITP) and 20 normal children (control group). Expression of TLR2 and TLR4 on platelets and CD86 on lymphocytes were detected by flow cytometry. Serum concentrations of IL-2, IL-4, IL-10 and IFN-γ were measured using ABC-ELISA. RESULTS: The expression of CD41+TLR2+ and CD61+TLR4+ in the AITP and the CITP groups were significantly lower than those in the control group (P<0.01). The AITP group had lower expression of CD41+TLR2+ and CD61+TLR4+ than the CITP group (P<0.01). The expression of CD86+ in the AITP and the CITP groups was significantly higher than that in the control group (P<0.01). The serum concentrations of IL-2, IL-4, IL-10 and IFN-γ in the AITP and the CITP groups were significantly higher than those in the control group (P<0.05). There was a positive correlation between CD41+TLR2+ and CD61+TLR4+ expression. CD41+TLR2+ and CD61+TLR4+ expression were negatively correlated with CD86+ expression and serum concentrations of IL-2, IL-4 and IL-10. CONCLUSIONS: The detections of TLR2 and TLR4 on platelets, CD86 on lymphocytes and serum concentrations of IL-2, IFN-γ, IL-4 and IL-10 are of great value in understanding the pathogenesis and predicting types of ITP in children.［Chin J Contemp Pediatr, 2009, 11 (10):797-801］
特发性血小板减少性紫癜 / Toll样受体 / CD86 / 细胞因子 / 儿童
Idiopathic thrombocytopenic purpura / Toll-like receptor / CD86 / Cytokine / Child
［1］Geddis AE, Balduini CL. Diagnosis of immune thrombocytopenic purpura in children［J］. Curr Opin Hematol, 2007, 14(5):520-525.
［2］罗春华，廖清奎.特发性血小板减少性紫癜诊疗建议［J］.中华儿科杂志, 1999, 37(1):50-51.
［3］Brikos C, O′Neill LA. Signalling of toll-like receptors［J］. Handb Exp Pharmacol, 2008, 183:21-50.
［4］Wazna E. Platelet-mediated regulation of immunity［J］. Postepy Hig Med Dosw (Online), 2006, 60:265-277.
［5］Sprague DL, Sowa JM. The role of platelet CD154 in the modulation in adaptive immunity［J］. Immunol Res, 2007, 39(3):185-193.
［6］Pitchford SC. Defining a role for platelets in allergic inflammation［J］. Biochem Soc Trans, 2007, 35(5):1104-1108.
［7］Cognasse F, Hamzeh H, Chavarin P, Acquart S, Genin C, Garraud O. Evidence of Toll-like receptor molecules on human platelets ［J］. Immunol Cell Biol, 2005, 83(2):196-198.
［8］Musaji A, Meite M, Detalle L, Franquin S, Cormont F, Préat V, et al. Enhancement of autoantibody pathogenic by viral infections in mouse models of anemia and thrombocytopenia ［J］. Autoimmun Rev, 2005, 4(4):247-252.
［9］Aslam R, Speck ER, Kim M, Crow AR, Bang KW, Nestel FP, et al. Platelet Toll-like receptor expression modulates lipopolysaccharide-induced thrombocytopenia and tumor necrosis factor-alpha production in vivo ［J］. Blood, 2006, 107(2):637-641.
［10］Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response［J］. Science, 2006, 311(5768):1770-1773.
［11］张春梅, 赵春亭, 滕清良, 杨宪勇, 李毅, 孙兆刚. 特发性血小板减少性紫癜患者外周血淋巴细胞标志物的表达及意义 ［J］.中华血液学杂志, 2005, 26(3):184-185.
［12］彭军，侯明.特发性血小板减少性紫癜中共刺激信号的作用研究［J］.中国实验血液学杂志, 2006, 14(5):1053-1055.
［13］Zhang XL, Peng J, Sun JZ, Guo CS, Yu Y, Wang ZG, et al. Modulation of immune response with cytotoxic T-lymphocyte-associated antigen 4 immunoglobulin-induced anergic T cells in chronic idiopathic thrombocytopenic purpura ［J］. Thromb Haemost, 2008, 6(1):158-165.
［14］Chang-Lin WU, Jian-Cheng XU, Fang LI, Hong XI, Xue-Min ZH, Qun CH, et al. Polarization and apoptosis of T cell subsets in idiopathic thrombocytopenic purpura［J］. Int J Lab Hematol, 2007, 29(3):177-184.
［15］赵春红，侯明.特发性血小板减小性紫癜的细胞免疫异常研究进展［J］.中国实验血液学杂志, 2006, 14(5):1045-1048.
［16］Culic S, Labar B, Marusic A, Salamunic I. Correlations among age, cytokines, lymphocyte subtypes, and platelet counts in autoimmune thrombocytopenic purpura［J］. Pediatr Blood Cancer, 2006, 47(5):671-674.
［17］Asai Y, Makimura Y, Ogawa T. Toll-like receptor 2-mediated dendritic cell activation by a Porphyromonas gingivalis synthetic lipopeptide［J］ . Med Microbiol, 2007, 56(4):459-465.
［18］Cairns BA, Barnes CM, Mlot S, Meyer AA, Maile R. Toll-like receptor 2 and 4 ligation results in complex altered cytokine profiles ［J］.Trauma, 2008, 64(4):1069-1077.
