CD40―CD40L在儿童持续性免疫性血小板减少症发病机制中作用研究.docVIP

CD40―CD40L在儿童持续性免疫性血小板减少症发病机制中作用研究 　　[摘要] 目的 通过检测CD40-CD40L在持续性免疫性血小板减少症（Persistent ITP）患儿外周血单个核细胞中的表达情况，以揭示其在儿童持续性ITP发病机制中的作用。 方法 应用流式细胞术检测20例持续性ITP患儿治疗前后及20例对照组儿童外周血单个核细胞中CD40-CD40L的表达情况，用ELISA法检测血小板抗体（PAIgG）。 结果 与对照组比较，CD40和CD40L治疗前后的表达均增高（P0.05）；CD40、CD40L的表达与PAIgG均呈正相关（r分别为0.713、0.746，P0.05）。 结论 CD40-CD40L共刺激信号异常可能为儿童持续性ITP发病机制之一，阻断此共刺激途径可能获得较好的治疗效果。 　　[关键词] CD40；CD40L；免疫性血小板减少症；儿童；持续性；发病机制 　　[中图分类号] R593.2 [文献标识码] B [文章编号] 2095-0616（2014）07-61-03 　　The Effect of CD40 and CD40L in pathogenesis of children with persistent immune thrombocytopenia 　　DENG Caiyan MA Zhanmin HU Yulian 　　Department of Pediatrics， Zhengzhou Maternal and Child Health Hospital， Zhengzhou 450012， China 　　[Abstract] Objective To investigate the expression of CD40 and CD40L in peripheral blood mononuclear cells of patients with childhood Persistent immune thrombocytopenia（Persistent ITP）， and to explore their possible roles in the pathogenesis of the disease. Methods The positivity rates of CD40 and CD40L in peripheral blood mononuclear cells were measured by flow cytometry in 20 Persistent ITP patients （prior treatment and post treatment） and 20 normal controls. Platelet-associated antibody（PAIgG） were detected by enzyme linked immunosorbent assay （ELISA） technique. Results Compared with controls， the expression of CD40 and CD40L were higher in both prior treatment group and post treatment group（P0.01，P0.05）， Compared with post treatment group， the expression of CD40 in prior treatment group were higher（P0.05=. The expression of CD40 and CD40L had positive correlation with PAIgG （r=0.713， 0.746； P0.05）. Conclusion CD40 and CD40L pathway may play important roles in the pathogenesis of Persistent ITP， and it is possible to be a good therapeutic target if we can obstruct this way. 　　[Key words] CD40； CD40L； ITP； Children； Persistent； Pathogenesis 　　免疫性血小板减少症（immune thrombocytopenia，ITP）是儿童时期常见的自身免疫出血性疾病，且近年来持续性和慢性ITP发病呈增多趋势，激素、免疫球蛋白等常规治疗效果差，不良反应多，病情迁延不愈，给家庭造成极大的心理和经济负担。大量研究证实，血小板抗体是