Expression and clinical significance of immune cell subsets in elderly patients with primary immune thrombocytopenia_West China Medical Journal

Authors：

BAO Weiying , FAN Yanqin , LIU Yuan , FAN Lu , KE Jin , WANG Hengshi , ZHU Ruifeng , XIAO Sufang , ZHANG Shanlan ,  HU Ximei

Department of Hematology, the Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (preparatory stage), Shanghai 201699, P. R. China;

Corresponding author：

HU Ximei, Email: hxmfzr@163.com

Keywords：

Primary immune thrombocytopenia; elderly patients; T lymphocyte subsets; natural killer cells; CD19⁺B cells

DOI：

10.7507/1002-0179.202108263

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Objective To investigate the expression and clinical significance of T lymphocyte subsets, natural killer (NK) cells and CD19⁺ B cells in the elderly with primary immune thrombocytopenia (ITP) before and after treatment. Methods The elderly ITP patients diagnosed and treated in the Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (preparatory stage) between January 2014 and June 2019 were retrospectively selected as the observation group. The healthy elderly in the same period were selected as the control group. According to the treatment, the observation group was divided into effective group and ineffective group. The expression levels of T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺), NK cells and CD19⁺ B cells were observed and analyzed. Results A total of 75 subjects were included, including 35 in the observation group and 40 in the control group. The total effective rate was 85.71% (30/35). Before treatment, the expression levels of T lymphocyte subsets (CD3⁺, CD4⁺ and CD4⁺/CD8⁺) in the observation group were lower than those in the control group (P<0.05). There was no significant difference in other indexes between the two groups (P>0.05). After treatment, except for CD8⁺, the expression levels of T lymphocyte subsets (CD3⁺, CD4⁺ and CD4⁺/CD8⁺) in the observation group were higher than those before treatment (P<0.05). The expression levels of NK cells and CD19⁺ B cells were lower than those before treatment (P<0.05). The expression levels of T lymphocyte subsets (CD3⁺, CD4⁺ and CD4⁺/CD8⁺) in the effective group were higher than those before treatment (P<0.05), while the expression level of CD19⁺ B cells was lower than that before treatment (P<0.05). There was no significant difference in other indexes before and after treatment (P>0.05). There was no significant difference in the expression levels of T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺), NK cells and CD19⁺ B cells in the ineffective group before and after treatment (P>0.05). Conclusions T lymphocyte subsets are abnormal in elderly ITP patients. The immune abnormality of T lymphocyte may be one of the reasons for elderly patients with ITP. With the improvement of therapeutic effect, immune cell subsets have also been improved.

Citation： BAO Weiying, FAN Yanqin, LIU Yuan, FAN Lu, KE Jin, WANG Hengshi, ZHU Ruifeng, XIAO Sufang, ZHANG Shanlan, HU Ximei. Expression and clinical significance of immune cell subsets in elderly patients with primary immune thrombocytopenia. West China Medical Journal, 2022, 37(5): 733-737. doi: 10.7507/1002-0179.202108263 Copy

1.	阮毅燕, 陈瑜毅, 唐文珏, 等. 特发性血小板减少性紫癜患儿细胞免疫功能变化及临床意义. 医学研究杂志, 2017, 46(2): 43-45.
2.	Frederiksen H, Maegbaek ML, Nørgaard M. Twenty-year mortality of adult patients with primary immune thrombocytopenia: a Danish population-based cohort study. Br J Haematol, 2014, 166(2): 260-267.
3.	中华医学会血液学分会血栓与止血学组. 成人原发免疫性血小板减少症诊断与治疗中国指南 (2020 年版). 中华血液学杂志, 2020, 41(8): 617-623.
4.	Segal JB, Powe NR. Prevalence of immune thrombocytopenia: analyses of administrative data. J Thromb Haemost, 2006, 4(11): 2377-2383.
5.	Audia S, Mahévas M, Samson M, et al. Pathogenesis of immune thrombocytopenia. Autoimmun Rev, 2017, 16(6): 620-632.
6.	McKenzie CG, Guo L, Freedman J, et al. Cellular immune dysfunction in immune thrombocytopenia (ITP). Br J Haematol, 2013, 163(1): 10-23.
7.	Hou Y, Feng Q, Xu M, et al. High-dose dexamethasone corrects impaired myeloid-derived suppressor cell function via Ets1 in immune thrombocytopenia. Blood, 2016, 127(12): 1587-1597.
8.	Ebbo M, Audonnet S, Grados A, et al. NK cell compartment in the peripheral blood and spleen in adult patients with primary immune thrombocytopenia. Clin Immunol, 2017, 177: 18-28.
9.	杨蕾, 庄芸, 钱锡峰, 等. 老年免疫性血小板减少症患者外周血 T 淋巴细胞亚群检测及其临床意义. 临床血液学杂志, 2015, 28(3): 384-388, 391.
10.	李艳秋, 牛挺. 原发免疫性血小板减少症研究进展. 华西医学, 2012, 27(10): 1570-1574.
11.	Zufferey A, Kapur R, Semple JW. Pathogenesis and Therapeuti Mechanisms in immune thrombocytopenia (ITP). J Clin Med, 2017, 6(2): 16.
12.	Swinkels M, Rijkers M, Voorberg J, et al. Emerging concepts in immune thrombocytopenia. Front Immunol, 2018, 9: 880.
13.	Hua F, Ji L, Zhan Y, et al. Aberrant frequency of IL-10-producing B cells and its association with Treg/Th17 in adult primary immune thrombocytopenia patiens. Biomed Tes Int, 2014, 2014: 571302.
14.	Xu LL, Fu HX, Zhang JM, et al. Impaired function of bone marrow mesenchymal stem cells from immune thrombocytopenia patients in inducing regulatory dendritic cell differentiation through the Notch-1/Jagged-1 signaling pathway. Stem Cells Dev, 2017, 26(22): 1648-1661.
15.	吴晓勇, 陈广雷, 王云龙, 等. T细胞与免疫性血小板减少症发病机制的相关性研究进展. 山东医药, 2017, 57(4): 101-104.
16.	朱玲玲, 张彦, 刘开蕾, 等. 原发性免疫性血小板减少症患者治疗前后 T 淋巴细胞亚群变化的临床意义. 中国医药科学, 2018, 8(17): 205-207.
17.	Nishimoto T, Okazaki Y, Numajiri M, et al. Mouse immune thrombocytopenia is associated with Th1 bias and expression of activating Fcγ receptors. Int J Hematol, 2017, 105(5): 598-605.
18.	Stasi R. Immune thrombocytopenia: pathophysiologic and clinical update. Semin Thromb Hemost, 2012, 38(5): 454-462.
19.	刘小群. CD4⁺CD25⁺调节性 T 细胞在特发性血小板减少性紫癜发病机制中的作用. 国际儿科学杂志, 2011, 38(5): 437-440.
20.	佟海侠, 马良艳, 陆春伟, 等. 特发性血小板减少性紫瘢患者外周血淋巴细胞亚群和调节性 T 细胞的变化及临床意义. 中国医科大学学报, 2011, 40(10): 934-937.
21.	郭新红, 范佳鑫, 阿依姆妮萨·阿卜杜热合曼, 等. CD4⁺CD25⁺CD127low 调节性 T 细胞及相关细胞因子与慢性特发性血小板减少性紫癜的研究. 中国免疫学杂志, 2011, 27(1): 73-75.
22.	张恒, 潘歆, 陈志刚, 等. 原发免疫性血小板减少症患者血小板表面 CD41、CD62P 及 T 淋巴细胞亚群水平变化. 山东医药, 2014, 54(32): 60-62.
23.	李文倩, 王小蕊, 李建平, 等. 免疫性血小板减少症患者免疫抑制治疗前后免疫细胞亚群及细胞因子谱分析. 中华内科杂志, 2016, 55(2): 111-115.
24.	Wen R, Wang Y, Hong Y, et al. Cellular immune dysregulation in the pathogenesis of immune thrombocytopenia. Blood Coagul Fibrinolysis, 2020, 31(2): 113-120.

1. 阮毅燕, 陈瑜毅, 唐文珏, 等. 特发性血小板减少性紫癜患儿细胞免疫功能变化及临床意义. 医学研究杂志, 2017, 46(2): 43-45.
2. Frederiksen H, Maegbaek ML, Nørgaard M. Twenty-year mortality of adult patients with primary immune thrombocytopenia: a Danish population-based cohort study. Br J Haematol, 2014, 166(2): 260-267.
3. 中华医学会血液学分会血栓与止血学组. 成人原发免疫性血小板减少症诊断与治疗中国指南 (2020 年版). 中华血液学杂志, 2020, 41(8): 617-623.
4. Segal JB, Powe NR. Prevalence of immune thrombocytopenia: analyses of administrative data. J Thromb Haemost, 2006, 4(11): 2377-2383.
5. Audia S, Mahévas M, Samson M, et al. Pathogenesis of immune thrombocytopenia. Autoimmun Rev, 2017, 16(6): 620-632.
6. McKenzie CG, Guo L, Freedman J, et al. Cellular immune dysfunction in immune thrombocytopenia (ITP). Br J Haematol, 2013, 163(1): 10-23.
7. Hou Y, Feng Q, Xu M, et al. High-dose dexamethasone corrects impaired myeloid-derived suppressor cell function via Ets1 in immune thrombocytopenia. Blood, 2016, 127(12): 1587-1597.
8. Ebbo M, Audonnet S, Grados A, et al. NK cell compartment in the peripheral blood and spleen in adult patients with primary immune thrombocytopenia. Clin Immunol, 2017, 177: 18-28.
9. 杨蕾, 庄芸, 钱锡峰, 等. 老年免疫性血小板减少症患者外周血 T 淋巴细胞亚群检测及其临床意义. 临床血液学杂志, 2015, 28(3): 384-388, 391.
10. 李艳秋, 牛挺. 原发免疫性血小板减少症研究进展. 华西医学, 2012, 27(10): 1570-1574.
11. Zufferey A, Kapur R, Semple JW. Pathogenesis and Therapeuti Mechanisms in immune thrombocytopenia (ITP). J Clin Med, 2017, 6(2): 16.
12. Swinkels M, Rijkers M, Voorberg J, et al. Emerging concepts in immune thrombocytopenia. Front Immunol, 2018, 9: 880.
13. Hua F, Ji L, Zhan Y, et al. Aberrant frequency of IL-10-producing B cells and its association with Treg/Th17 in adult primary immune thrombocytopenia patiens. Biomed Tes Int, 2014, 2014: 571302.
14. Xu LL, Fu HX, Zhang JM, et al. Impaired function of bone marrow mesenchymal stem cells from immune thrombocytopenia patients in inducing regulatory dendritic cell differentiation through the Notch-1/Jagged-1 signaling pathway. Stem Cells Dev, 2017, 26(22): 1648-1661.
15. 吴晓勇, 陈广雷, 王云龙, 等. T细胞与免疫性血小板减少症发病机制的相关性研究进展. 山东医药, 2017, 57(4): 101-104.
16. 朱玲玲, 张彦, 刘开蕾, 等. 原发性免疫性血小板减少症患者治疗前后 T 淋巴细胞亚群变化的临床意义. 中国医药科学, 2018, 8(17): 205-207.
17. Nishimoto T, Okazaki Y, Numajiri M, et al. Mouse immune thrombocytopenia is associated with Th1 bias and expression of activating Fcγ receptors. Int J Hematol, 2017, 105(5): 598-605.
18. Stasi R. Immune thrombocytopenia: pathophysiologic and clinical update. Semin Thromb Hemost, 2012, 38(5): 454-462.
19. 刘小群. CD4⁺CD25⁺调节性 T 细胞在特发性血小板减少性紫癜发病机制中的作用. 国际儿科学杂志, 2011, 38(5): 437-440.
20. 佟海侠, 马良艳, 陆春伟, 等. 特发性血小板减少性紫瘢患者外周血淋巴细胞亚群和调节性 T 细胞的变化及临床意义. 中国医科大学学报, 2011, 40(10): 934-937.
21. 郭新红, 范佳鑫, 阿依姆妮萨·阿卜杜热合曼, 等. CD4⁺CD25⁺CD127low 调节性 T 细胞及相关细胞因子与慢性特发性血小板减少性紫癜的研究. 中国免疫学杂志, 2011, 27(1): 73-75.
22. 张恒, 潘歆, 陈志刚, 等. 原发免疫性血小板减少症患者血小板表面 CD41、CD62P 及 T 淋巴细胞亚群水平变化. 山东医药, 2014, 54(32): 60-62.
23. 李文倩, 王小蕊, 李建平, 等. 免疫性血小板减少症患者免疫抑制治疗前后免疫细胞亚群及细胞因子谱分析. 中华内科杂志, 2016, 55(2): 111-115.
24. Wen R, Wang Y, Hong Y, et al. Cellular immune dysregulation in the pathogenesis of immune thrombocytopenia. Blood Coagul Fibrinolysis, 2020, 31(2): 113-120.

West China Medical Journal

Expression and clinical significance of immune cell subsets in elderly patients with primary immune thrombocytopenia

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