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. 2021 Mar 18:14:937-947.
doi: 10.2147/IJGM.S298888. eCollection 2021.

Imbalance of T Lymphocyte Subsets in Adult Immune Thrombocytopenia

Xiuxiu Lin  1 , Anhui Xu  1 , Li Zhou  1 , Na Zhao  1 , Xinhui Zhang  2 , Jin Xu  3 , Shanglong Feng  2 , Changcheng Zheng  1
Affiliations

Imbalance of T Lymphocyte Subsets in Adult Immune Thrombocytopenia

Xiuxiu Lin et al. Int J Gen Med. .

Abstract

Background: Primary immune thrombocytopenia (ITP) is defined as an acquired autoimmune disease characterized by isolated thrombocytopenia. This work is to further clarify the relationship between T cell immune dysfunction and the pathogenesis of ITP.

Methods: 37 adult patients with ITP were selected and were classified into newly diagnosed ITP (nITP, n = 13), persistent ITP (pITP, n = 6) and chronic ITP (cITP n = 18). The frequency of cytotoxic T lymphocytes (Tc1, Tc2, and Tc17) and helper T cells (Th1, Th2, and Th17), Tregs, and the expression of chemokine receptors and PD-1 on CD4+ T cells were investigated by flow cytometry. Plasma levels of T cell-related cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, IL-17) were measured by cytometric beads array (CBA).

Results: The percentage of Tc1 in cITP was greatly higher than nITP and healthy controls (p < 0.05, p < 0.01). The percentage of Treg in nITP and cITP groups was remarkably lower than those in healthy control group (p < 0.05, p < 0.001); and according to platelet count analysis (PLT<50x109/L or PLT>50x109/L), Treg cells in ITP group were significantly lower than those in healthy control group (p < 0.001, p < 0.05). The percentage of CD4+CXCR3+ of cITP was significantly higher than healthy controls and nITP (p < 0.01, p < 0.05). The percentage of CD4+CCR6+ in cITP was significantly higher than healthy controls and nITP (p < 0.001, p < 0.05). The expression of PD-1 in cITP patients was higher than healthy control (p < 0.05), but there was no significant difference among nITP, pITP and cITP (p = 0.25). The levels of IL-2, IFN-γ and TNFα in nITP group and cITP group were significantly higher than those in healthy control group (p < 0.01, p < 0.05; p < 0.01, p < 0.05; p < 0.05, p < 0.05), and the level of IL-10 in nITP group was significantly higher than that in pITP group (p < 0.05).

Conclusion: Our results suggest that T lymphocyte immune dysfunction does exist in adult ITP patients and plays an important role in the pathogenesis of ITP.

Keywords: T helper cells; cytotoxic T lymphocyte; primary immune thrombocytopenia; regulatory T cells.

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Conflict of interest statement

The authors of this manuscript have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The percentage of Tc increased in chronic ITP.
Figure 2
Figure 2
The percentage of helper cell T cells in ITP.
Figure 3
Figure 3
The percentage of Treg decreased in ITP patients.
Figure 4
Figure 4
The expression of CXCR3, CCR6 and PD1 on CD4+ T cells increased in ITP patients.
Figure 5
Figure 5
Serum levels of IL-2, IFN-γ, TNF-α in ITP patients were increased.
See this image and copyright information in PMC

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