Involvement of levels of Toll like receptor-4 in monocytes, CD4+ T-lymphocyte subsets, and cytokines in patients with immune thrombocytopenic purpura
Involvement of levels of Toll like receptor-4 in monocytes, CD4+ T-lymphocyte subsets, and cytokines in patients with immune thrombocytopenic purpura
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DOI：
10.1016/j.thromres.2013.04.025
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发表时间：
2013-08-01
影响因子：
7.5
通讯作者：
Ma Liping
中科院分区：
文献类型：
--
作者：
Liu Hongyun;Ouyang Xianfeng;Ma Liping
前言：Toll样受体已被发现与免疫介导性疾病有关，但目前尚不清楚它们是否在免疫性血小板减少性紫癜(ITP)，尤其是TLR4中发挥作用。CD4+T淋巴细胞异常，包括Th17、Th1、Th2和调节性T细胞(Treg)，被认为是ITP的重要因素。TLR4在ITP中的表达及其与Th17的关系研究较少。材料与方法：本研究检测了70例ITP患者和31例正常对照单核细胞TLR4的表达、血浆IL-23、IL-17水平及Th17、Th1、Th2细胞亚群的变化。结果：ITP患者外周血中TLR4表达水平明显高于正常对照组(P=0.001；T细胞亚群P=0.001；T细胞亚群P=0.014；T细胞亚群T细胞亚群P=0.001)。IL-23和IL-2水平升高(P=0.022；P=0.025)，Th2相对水平和IL-17浓度在两组间无明显差异(P=0.446；P=0.316)。TLR4与TREG水平呈显著负相关(r=-0.544，p<；0.001)，而IL-2与IL-23水平呈显著正相关(r=0.441，p=0.004)。结论：TLR4、CD4+T细胞(Th1、Th17、Treg细胞)及相关细胞因子(IL-23、IL-2)可能参与了ITP的发病过程。TLR4可能通过TLR4-细胞因子-CD4+T细胞途径发挥作用。(C)2013爱思唯尔有限公司。保留所有权利。
Introduction: Toll-like receptors have been found to be associated with immune-mediated diseases but it is still not clear whether they play a role in immune thrombocytopenic purpura (ITP), especially TLR4. CD4 + T-lymphocyte abnormalities, including Th17, Th1, Th2, and regulator T cell (Treg), are considered important in ITP. There have been few studies regarding the expression of TLR4 and the relationships between TLR4 and Th17 levels in ITP.Materials and Methods: In this study, we evaluated the expression of TLR4 in monocytes, the plasma concentrations of IL-23, IL-17 and the profiles of Th17, Th1, Th2 cells in 70 patients with ITP and 31 healthy controls. In addition, we evaluated IL-2 and Treg cells in 46 cases of 70 patients with ITP and the same 31 controls.Results: Higher levels of TLR4 expression, higher relative numbers of Th17 and Th1 cells and lower levels of Treg cells were observed in patients when compared with controls (p = 0.001 for TLR4; p < 0.001 for Th17; p = 0.014 for Th1; p = 0.001 for Treg). The levels of IL-23 and IL-2 were increased (p = 0.022 for IL-23; p = 0.025 for IL-2), the relative levels of Th2 and concentrations of IL-17 were similar across both groups (p = 0.446 for Th2; p = 0.316 for IL-17). A significant negative correlation was observed between levels of TLR4 and Treg(r = -0.544, p < 0.001), but a significantly positive correlation was observed between IL-2 and IL-23 concentration in patients (r = 0.441, p = 0.004). Neither the correlation between TLR4 and the other CD4(+) T cells and cytokines nor the correlation between the three cytokines and CD4+ T cells was found to be statistically significant.Conclusions: Our data showed that TLR4, CD4+ T cells (Th1, Th17 and Treg cells) and related cytokines (IL-23, IL-2) may take part in the pathogenesis of ITP. TLR4 may play a role through the TLR4-cytokine-CD4+ T lymphocyte cell pathway. (c) 2013 Elsevier Ltd. All rights reserved.