Shenzhen Institute of Pediatrics

Shenzhen, China

Shenzhen Institute of Pediatrics

Shenzhen, China
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Yao X.,Shenzhen Institute of Pediatrics | Li C.-R.,Shenzhen Institute of Pediatrics | Wang G.-B.,Shenzhen Institute of Pediatrics | Yang J.,Shenzhen Institute of Pediatrics | Li C.-G.,Shenzhen Institute of Pediatrics
Chinese Journal of Microbiology and Immunology (China) | Year: 2013

Objective: To investigate the role of T follicular helper (Tfh) cells in the immunopathogenesis of persistent immune thrombocytopenic purpura (pITP). Methods: Twenty children with pITP and twenty healthy controls were enrolled in this study. The proportion of CD4+CXCR5+ ICOShighPD-1highT (cTfh) cells and the expression of ICOSL on CD19+B cells in peripheral blood of the patients and healthy subjects were analyzed by flow cytometry. The expressions of Bcl-6, c-Maf, IL-21 and ICOSL at mRNA level were detected by real-time PCR. The plasma concentrations of IL-2, IL-6 and IL-21 were determined by ELISA. Results: (1) Compared with the healthy controls, the proportions of cTfh cells increased significantly in patients with pITP [(17.45 ± 9.04)% vs. (7.57 ± 2.57)%, P < 0.05], but decreased with the treatment of dexamethasone (DEX) for 7 days [(5.93 ± 1.64)% vs. (17.45 ± 9.04)%, P < 0.05]. (2) The expression of Bcl-6, c-Maf and IL-21 at mRNA level in patients with pITP were higher than those in healthy controls (P < 0.05). (3) Compared with healthy controls, the expression of ICOSL at mRNA and protein levels in CD19+B cells were significantly up-regulated in patients with pITP (P < 0.05), which showed no significant changes after treatment with DEX (P > 0.05). (4) The plasma concentration of IL-21 was remarkably elevated in patients with pITP, regardless of DEX treatment (P < 0.05). But the plasma concentrations of IL-2 and IL-6 showed no significant changes compared with control group (P > 0.05). Conclusion: The immunopathogenesis of persistent immune thrombocytopenic purpura might be associated with the hyper-activation of Tfh cells caused by excessive expression of ICOSL and IL-21. The persistent high expression of ICOSL and IL-21 might be one of the important factors resulting in the recurrence of pITP in children. Copyright © 2013 by the Chinese Medical Association.

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