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, 陳瑜毅, 唐文玨, 等. 特發性血小板減少性紫癜患兒細胞免疫功能變化及臨床意義. 醫學研究雜志, 2017, 46(2): 43-45.
2.	Frederiksen H, Maegbaek ML, N?rgaard 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.	中華醫學會血液學分會血栓與止血學組. 成人原發免疫性血小板減少癥診斷與治療中國指南 (2020 年版). 中華血液學雜志, 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.	楊蕾, 莊蕓, 錢錫峰, 等. 老年免疫性血小板減少癥患者外周血 T 淋巴細胞亞群檢測及其臨床意義. 臨床血液學雜志, 2015, 28(3): 384-388, 391.
10.	李艷秋, 牛挺. 原發免疫性血小板減少癥研究進展. 華西醫學, 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.	吳曉勇, 陳廣雷, 王云龍, 等. T細胞與免疫性血小板減少癥發病機制的相關性研究進展. 山東醫藥, 2017, 57(4): 101-104.
16.	朱玲玲, 張彥, 劉開蕾, 等. 原發性免疫性血小板減少癥患者治療前后 T 淋巴細胞亞群變化的臨床意義. 中國醫藥科學, 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.	劉小群. CD4⁺CD25⁺調節性 T 細胞在特發性血小板減少性紫癜發病機制中的作用. 國際兒科學雜志, 2011, 38(5): 437-440.
20.	佟海俠, 馬良艷, 陸春偉, 等. 特發性血小板減少性紫瘢患者外周血淋巴細胞亞群和調節性 T 細胞的變化及臨床意義. 中國醫科大學學報, 2011, 40(10): 934-937.
21.	郭新紅, 范佳鑫, 阿依姆妮薩·阿卜杜熱合曼, 等. CD4⁺CD25⁺CD127low 調節性 T 細胞及相關細胞因子與慢性特發性血小板減少性紫癜的研究. 中國免疫學雜志, 2011, 27(1): 73-75.
22.	張恒, 潘歆, 陳志剛, 等. 原發免疫性血小板減少癥患者血小板表面 CD41、CD62P 及 T 淋巴細胞亞群水平變化. 山東醫藥, 2014, 54(32): 60-62.
23.	李文倩, 王小蕊, 李建平, 等. 免疫性血小板減少癥患者免疫抑制治療前后免疫細胞亞群及細胞因子譜分析. 中華內科雜志, 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, 陳瑜毅, 唐文玨, 等. 特發性血小板減少性紫癜患兒細胞免疫功能變化及臨床意義. 醫學研究雜志, 2017, 46(2): 43-45.
2. Frederiksen H, Maegbaek ML, N?rgaard 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. 中華醫學會血液學分會血栓與止血學組. 成人原發免疫性血小板減少癥診斷與治療中國指南 (2020 年版). 中華血液學雜志, 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. 楊蕾, 莊蕓, 錢錫峰, 等. 老年免疫性血小板減少癥患者外周血 T 淋巴細胞亞群檢測及其臨床意義. 臨床血液學雜志, 2015, 28(3): 384-388, 391.
10. 李艷秋, 牛挺. 原發免疫性血小板減少癥研究進展. 華西醫學, 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. 吳曉勇, 陳廣雷, 王云龍, 等. T細胞與免疫性血小板減少癥發病機制的相關性研究進展. 山東醫藥, 2017, 57(4): 101-104.
16. 朱玲玲, 張彥, 劉開蕾, 等. 原發性免疫性血小板減少癥患者治療前后 T 淋巴細胞亞群變化的臨床意義. 中國醫藥科學, 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. 劉小群. CD4⁺CD25⁺調節性 T 細胞在特發性血小板減少性紫癜發病機制中的作用. 國際兒科學雜志, 2011, 38(5): 437-440.
20. 佟海俠, 馬良艷, 陸春偉, 等. 特發性血小板減少性紫瘢患者外周血淋巴細胞亞群和調節性 T 細胞的變化及臨床意義. 中國醫科大學學報, 2011, 40(10): 934-937.
21. 郭新紅, 范佳鑫, 阿依姆妮薩·阿卜杜熱合曼, 等. CD4⁺CD25⁺CD127low 調節性 T 細胞及相關細胞因子與慢性特發性血小板減少性紫癜的研究. 中國免疫學雜志, 2011, 27(1): 73-75.
22. 張恒, 潘歆, 陳志剛, 等. 原發免疫性血小板減少癥患者血小板表面 CD41、CD62P 及 T 淋巴細胞亞群水平變化. 山東醫藥, 2014, 54(32): 60-62.
23. 李文倩, 王小蕊, 李建平, 等. 免疫性血小板減少癥患者免疫抑制治療前后免疫細胞亞群及細胞因子譜分析. 中華內科雜志, 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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