Changes and significance of helper T cells 17 and regulatory T cells in patients with chronic primary thrombocytopenia

Abstract

Objective To study the changes of helper T cells (Th) 17 and regulatory T cells (Treg) before and after therapy in patients with chronic primary thrombocytopenia(cITP), in order to explore their significance in pathogenesis and treatment of cITP. Methods From January 2012 to December 2015, a total of 31 patients with cITP who were treated in Heze Hospital of Traditional Chinese Medicine were included in this study.They were divided into effective group (n=22) and ineffective group (n=9) according to their treatment effects. Meanwhile, there were 21 healthy individuals for physical examination were also included in this study as control group (n=21). The proportion of plasma Th17, Treg and the ratio of Th17/Tregs before and after therapy in patients with cITP and healthy adults in control group were detected by flow cytometry. The data of Th17, Tregs and the ratio of Th17/Tregs were non-normal distributions, and measurement data were expressed as M(P25-P75). Mann-Whitney U test was used to compare the data among deffierent groups and between before and after therapy in the same group. The research subjects were told and signed the informed consent agreement.There were no significant differences among three groups in the age and aspects of gender ratio, etc.(P>0.05). Results ① Before therapy, proportion of plasma Th17, Tregs and the ratio of Th17/Tregs were no significance difference between effective group and ineffective group(Z=0.231, 0.243, 0.305; P=0.984, 0.993, 0.814), but compared with control group espectively, both effective group and ineffective group had statistically differences (Z=4.023, 5.317, 6.231, 4.892, 4.912, 6.042; P=0.002, 0.002, 0.001, 0.001, 0.003, 0.001). ② In effective group, there were significance differences in proportion of plasma Th17, Tregs and the ratio of Th17/Tregs between before and after therapy (Z=3.591, 3.225, 5.254; P=0.003, 0.006, 0.001); but after therapy, the difference was no statistically significant between effective group and control group (Z=0.342, 0.391, 0.328; P=0.871, 0.882, 0.789). ③ In ineffective group, there were no significance difference in proportion of plasma Th17, Tregs and the ratio of Th17/Tregs between before and after therapy (Z=0.207, 0.194, 0.284; P= 0.991, 0.996, 0.901). And after therapy, the differences still had statistically significance between ineffective group and control group(Z=4.358, 4.465, 5.612; P=0.002, 0.003, 0.001). Conclusions Th17 and Treg may participate in the occurrence and development of cITP. Patients with cITP have abnormal proportion of plasma Treg and Th17 and dysregulation of Treg/Th17. Targeted drugs targeting Treg/Th17 abnormalities are also expected to open up new avenues for the treatment of cITP. Key words: Thrombocytopenica, primary; Helper T cells 17; Regulatory T cells; Flow cytometry