The relationship between Th1/Th2 cytokine and glucocorticoidresistant idiopathic thrombocytopenia purpura

Objective To clarify the relationship between the response of the patients with idiopathic thrombocytopenia purpura (ITP)to glucocorticoid and Th1/Th2 cytokines in peroperal blood mononuclear cell (PBMC).Methods Adult chronic ITP patients were divided to glucocorticoid-sensitive groups and glucocorticoidresistant groups according their responces to glucocorticoid.Healthy volunteers were regarded as controls.The semiquantitative RT-PCR was used to detect the expression of Th1/Th2 cytokines in PBMC.ELISA was used to detect the TNF-α in plasma.Results Compared with controls,the levels of Th1 type cytokines IL-2,TNF-α and IFN-γwere increased in ITP patients (IL-2:1.27 ± 0.67 and 1.32 ± 0.61 vs 1.02 ± 0.57 ;TNF-α:1.21 ± 0.45 and 1.59 ± 0.79 vs 1.07 ± 0.51 ; IFN-γ:1.28 ± 0.49 and 1.35 ± 0.57 vs 1.11 ± 0.45,all P ＜ 0.05),while the levels of Th2 type cytokines IL-4 and IL-6 were decreased in ITP patients (IL-4:1.06 ±0.51 and 0.84 ±0.65 vs 1.37 ±0.53;IL-6:1.04 ± 0.61 and 0.98 ± 0.57 vs 1.31 ± 0.52,all P ＜ 0.05).The expression of TNF-α in plasma of ITP patients with glucocorticoid resistance (19.73 ± 4.66) pg/mL was significantly higher than that in the glucocorticoid-sensitive groups (13.69 ± 4.92) pg/mL and controls (7.51 ± 2.79) pg/mL,all P ＜ 0.05.Conclusions Imbalance of Th1/Th2 type cytokines may be correlated with the pathogenesis of ITP. Key words: Idiopathic thrombocytopenia purpura;  Glucocorticoid resistance;  Th1/Th2 cytokines; TNF-α