[Relationship of Peripheral Blood IL-37 Expression with T Lymphocytes Subsets and NK Cells in Patients with Primary Immune Thrombocytopenia].

OBJECTIVE: To study the correlation of IL-37 with T lymphocytes subsets and NK cells in ITP patients, and to explore its possible mechanisms involved in the pathogenesis of ITP. METHODS: Forty-five patients with newly diagnosed ITP(newly diagnosed group), 32 patients of complete remission (remission group) and 22 healthy persons(control group) were selected. The serum level of IL-37 in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The mRNA expression of IL-37, IL-17 and IL-18 in peripheral blood mononuclear cells（PBMNC） in 3 groups was measured by real-time fluorescence quantitative polymerase chain reaction (PCR). The number of IL-18Rα+CD4+ T cells and Tim-3+NK cells in the peripheral blood in 3 groups was detected by flow cytometry (FCM). 方法: 选取初诊组ITP 患者45 例，完全缓解组ITP 患者32例及正常对照组22例。采用酶联免疫吸附试验法( ELISA) 测定3 组外周血血清中IL-37水平，应用实时荧光定量聚合酶链式反应(PCR) 测定3 组外周单个核细胞内IL-37、IL-18、IL-17 mRNA 相对表达水平,采用流式细胞术(FCM) 检测3 组IL-18Rα+CD4+ T细胞比例，2组Tim-3+ NK细胞比例. 结果: 初诊组ITP患者血清IL-37水平高于缓解组患者及正常对照组（P<0.01）；初诊组IL-37 mRNA表达水平高于缓解组及正常对照组（P<0.01），缓解组IL-37 mRNA表达水平高于正常对照组（P<0.05）。初诊组IL-18、IL-17 mRNA表达水平均明显高于缓解组及正常对照组（P<0.01）。流式细胞术检测表明，初诊组的IL-18Rα+CD4+ T细胞比例比缓解组和对照组增高，且差异具有统计学意义。初诊组的Tim-3+ NK 细胞比例比对照组低，且差异具有统计学意义（P<0.01）;在ITP患者中，血清IL-37水平和IL-18Rα+CD4+ T细胞比例均与血小板数量呈负相关(r=-0.58; r=-0.48)，与CD4+ T细胞数、NK细胞数呈负相关(r=-0.29; r=-0.28)，与CD8+T细胞量呈正相关（r=0.329）. 结论: IL-37及其受体可能在ITP患者的CD4+ T细胞和NK细胞发挥免疫调节作用，IL-37可以成为免疫性血小板患者的治疗靶标.