title: [Preliminary study on the quantity and function of T follicular helper cells in the cytopenic patients with positive BMMNC-Coombs test].
abstract: OBJECTIVE
  To study the quantity and function of bone marrow (BM) T follicular helper (Tfh) cells of the cytopenia patients with positive bone marrow mononuclear cells (BMMNC)- Coombs test (also known as immuno-related pancytopenia, IRP), and explore the role of Tfh cells in the pathogenesis of IRP.
  
  
  METHODS
  Forty- three untreated IRP patients, 47 recovered IRP patients and 25 healthy donors were enrolled in this study. The percentages of Tfh cells, Tfh-related molecules ICOS, CD40L, IL-21 and Bcl-6 in BM were investigated by flow cytometry and semiquantitive RT-PCR.
  
  
  RESULTS
  The ratio of CD4⁺CXCR5⁺/CD4⁺ cells of untreated IRP patients [(28.79 ± 19.70)%] was significantly higher than that of recovered IRP patients [(21.15 ± 12.81)% ] and normal controls ([ 13.42 ± 6.72)% ](P<0.05). The ratio of CD4⁺CXCR5⁺ICOS⁺/CD4⁺CXCR5⁺ cells of untreated IRP patients [(5.05 ± 4.71)% ] was significantly higher than that of recovered IRP patients [(2.96 ± 2.89)% ] and normal controls [(2.99 ± 2.23)% ] (P<0.05). The ratio of CD4⁺CXCR5⁺CD40L⁺/CD4⁺CXCR5⁺ cells of untreated IRP patients [(5.87 ± 4.14)%] and recovered IRP patients [(6.52±5.47)%] were significantly higher than that of normal controls [(2.93 ± 2.92)%] (P<0.05). The ratio of intracytoplasmic CD4⁺CXCR5⁺IL-21⁺/CD4⁺CXCR5⁺ cells of untreated IRP patients [(8.20 ± 7.41)% ] and recovered IRP patients [(6.30 ± 6.03)% ] were significantly higher than that of normal controls [(3.43 ± 3.40)%] (P<0.05). The relative expressions of Bcl-6 mRNA in BMMNC were 0.625 ± 0.248, 0.485 ± 0.253, 0.306 ± 0.210 in three groups, respectively. The differences between untreated IRP patients, recovered IRP patients and normal controls were significant (P<0.05).
  
  
  CONCLUSIONS
  There exists increased quantity and hyperfunction of Tfh cells in the IRP patients, they may play important role in the pathogenesis of IRP. Tfh cells and their related effector molecules could be a potential therapeutic target for the disease.
authors.affiliation: Department of Hematology and Oncology, General Hospital, Tianjin Medical University, Tianjin 300052, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Rong
authors.initials: R
authors.lastname: Fu
authors.forename: Yi-hao
authors.initials: YH
authors.lastname: Wang
authors.forename: Hua-quan
authors.initials: HQ
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Li-juan
authors.initials: LJ
authors.lastname: Li
authors.forename: Hong-lei
authors.initials: HL
authors.lastname: Wang
authors.forename: Er-bao
authors.initials: EB
authors.lastname: Ruan
authors.forename: Wen
authors.initials: W
authors.lastname: Qu
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Wang
authors.forename: Guo-jin
authors.initials: GJ
authors.lastname: Wang
authors.forename: Yu-hong
authors.initials: YH
authors.lastname: Wu
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Jia
authors.initials: J
authors.lastname: Song
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Xing
authors.forename: Jing
authors.initials: J
authors.lastname: Guan
authors.forename: Zong-hong
authors.initials: ZH
authors.lastname: Shao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003298:Coombs Test; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007378:Interleukins / Q000378:metabolism; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D006377:T-Lymphocytes, Helper-Inducer / Q000166:cytology* / Q000378:metabolism*; D055815:Young Adult; D000098546:Interleukin-21
chemical_list: D007378:Interleukins; D000098546:Interleukin-21