Altered circulating T follicular helper cells in patients with chronic immune thrombocytopenia

Dai,Lan; He,Linyan; Wang,Zhaoyue; Bai,Xia; He,Yang; Cao,Lijuan; Zhu,Mingqing; Ruan,Changgeng

doi:10.3892/etm.2018.6508

Altered circulating T follicular helper cells in patients with chronic immune thrombocytopenia

Authors:
- Lan Dai
- Linyan He
- Zhaoyue Wang
- Xia Bai
- Yang He
- Lijuan Cao
- Mingqing Zhu
- Changgeng Ruan
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Affiliations: Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
Published online on: July 23, 2018 https://doi.org/10.3892/etm.2018.6508
Pages: 2471-2477
Copyright: © Dai et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to illuminate the role of circulating T follicular helper (TFH) cells in patients diagnosed with chronic immune thrombocytopenia (cITP). Fifty‑four patients with cITP and 30 age‑matched healthy control subjects were enrolled in the present study. TFH cell frequencies, expression of CD4+ TFH cell‑associated cytokines, including interleukin (IL)‑2, IL‑4, IL‑10 and IL‑21 and associated regulatory mRNA expression levels including Bcl‑6, c‑Maf, Blimp‑1 and PD‑1 pre‑ and post‑treatment with intravenous immunoglobulin and corticosteroids, were detected by flow cytometry, ELISA and reverse transcription‑quantitative polymerase chain reaction, respectively. TFH cell frequencies of patients were significantly higher compared with healthy controls pre‑treatment (P<0.05). Following treatment, significantly decreased percentages of TFH cells were present in cITP responders (P<0.05). Correlation analysis revealed that the number of TFH cells was negatively correlated with the platelet count in the peripheral blood. Furthermore, analysis of inflammatory cytokines indicated significant differences in serum interleukin (IL)‑21 and IL‑10 between pretreated patients and healthy controls (P<0.05). Additionally, transcription factor B‑cell lymphoma (Bcl)‑6, c‑Maf and programmed death‑ligand (PD)‑1 mRNA expression levels were significantly different between cITP patients prior to treatment and the healthy controls (P<0.05). However, the expression levels of Bcl‑6, C‑Maf and PD‑1 mRNA were significantly changed post‑treatment (P<0.05). These data demonstrated that circulating TFH cells and CD4+ TFH cell‑associated cytokines may serve a role in cITP. The findings suggest that the overactivation of TFH cells may contribute to the immunopathogenesis of cITP, thus blocking the pathway of TFH cells may be reasonable for therapeutic intervention.

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