Correction of th1-dominant cytokine profiles by high-dose dexamethasone in patients with chronic idiopathic thrombocytopenic purpura
Correction of th1-dominant cytokine profiles by high-dose dexamethasone in patients with chronic idiopathic thrombocytopenic purpura
复制标题
大剂量地塞米松纠正慢性特发性血小板减少性紫癜患者的 th1 主导细胞因子谱
DOI：
10.1007/s10875-007-9111-1
复制
发表时间：
2007-11-01
影响因子：
9.1
通讯作者：
Hou, Ming
中科院分区：
文献类型：
--
作者：
Guo, Chengshan;Chu, Xiaoxia;Hou, Ming
为探讨大剂量地塞米松（HD-DXM）治疗慢性特发性血小板减少性紫癜（ITP）活动期患者对辅助性T细胞（Th）细胞因子谱的可能纠正作用，我们测定了52例患者连续4天口服40 mg/d DXM前后IFN-γ、IL-2、IL-4、IL-10和TGF-β 1的血浆水平。采用酶联免疫吸附法测定细胞因子水平。结果显示，所有患者均达到初步缓解，持续缓解率（SR）为46.15%。与正常对照组相比，治疗前血浆IFN-γ和IL-2水平均显著升高，而IL-4、IL-10和TGF-β 1水平显著降低（P < 0.01），表明ITP患者存在典型的Th 1优势细胞因子谱。HD-DXM治疗后，IFN-γ、IL-2明显降低（P < 0.01），IL-4、IL-10明显升高（P < 0.05）。HD-DXM治疗组与正常对照组比较差异无显著性（P > 0.05）。HD-DXM治疗后TGF-β 1水平也明显升高（P < 0.01），但仍低于正常对照组（P < 0.05）。随访期间，复发患者SRs细胞因子水平与治疗后比较无明显变化（P > 0.05），但IFN-γ和IL-2水平升高，IL-4、IL-10和TGF-β 1水平再次下降（P < 0.01）。我们的数据表明，HD-DXM是一个有效的初始治疗ITP，和Th 1细胞因子优势可以纠正HD-DXM。
To investigate the possible correcting of T helper (Th) cytokine profiles by high-dose dexamethasone (HD-DXM) therapy in chronic idiopathic thrombocytopenic purpura (ITP) with active disease, we determined the plasma levels of IFN-gamma, IL-2, IL-4, IL-10, and TGF-beta 1 in 52 patients before and after oral administration of 40 mg/day DXM for four consecutive days. The cytokine levels were measured by enzyme-linked immunosorbent assay. The results showed that initial responses were reached in all patients and sustained response (SR) rate is 46.15%. The pretreatment plasma levels of both IFN-gamma and IL-2 were significantly increased and those of IL-4, IL-10, and TGF-beta 1 significantly decreased, compared with those of the normal controls (P < 0.01), indicating a Th1-dominant cytokine profile typically found in ITP. After HD-DXM treatment, IFN-gamma and IL-2 were decreased (P < 0.01), whereas IL-4 and IL-10 were increased (P < 0.05). There was no significant difference between the HD-DXM-treated patients and the normal controls (P > 0.05). TGF-beta 1 was also increased (P < 0.01) after HD-DXM treatment, but still lower than that of the normal controls (P < 0.05). During following-up, the cytokine profiles in the SRs remained stable compared to the posttreatment level (P > 0.05), but IFN-gamma and IL-2 levels raised up, and IL-4, IL-10, and TGF-beta 1 levels reduced again in the relapsed patients (P < 0.01). Our data demonstrate that HD-DXM is an effective initial therapy for ITP, and the Th1 cytokine dominance could be corrected by HD-DXM.