title: [Significance of Plasma HMGB1, IFN-γ, IL-4 and TLR4 Expression on CD4+T Cell Surface in Patients with Immune Thrombocytopenia].
abstract: OBJECTIVE
  To investigate the effects of plasma HMGB1, IFN-γ, IL-4 and CD4+T cell surface TLR4 expression on the immune thrombocytopenia(ITP).
  
  
  METHODS
  Twenty-five patients diagnosed as ITP in our hospital from October 2014 to October 2015, and 20 healthy persons as controls were selected. The ELISA was used to detect the plasma levels of HMGB1, IFN-γ and IL-4 in 2 groups; the flow cytometry was used to detect the expression level of TLR4 on the surface of CD4+cells. The relatienship between different parameters was analyzed.
  
  
  RESULTS
  Before treatment, the plasma HMGB1 level in ITP group was significantly higher than that in control group (t=4.259, P<0.01), while after treatment it significantly decreased and close to level in control group (t=1.267, P>0.05). The plasma IFN-γ level detected in ITP group before and after treatment was not significantly different from level in control group (P>0.05), while the IL-4 level in ITP group before treatment was significantly lower than that in control grup (t=2.107, P<0.05), but the IL-4 level in ITP group after treatment was significantly higher than that in control group (t=2.107, P<0.05). The plasma IFN-γ/IL-4 ratio in ITP group before treatment was significantly higher than that in control group (t=5.436, P<0.01), but it obviously decreased and was slightly lower than that in control group after treatment. The expression level of TLR4 in ITP group before and after treatment was all significantly lower than that in control group (P<0.01). The HMGB1 level in ITP group was directly proportional to the CD3+content (r=0.824, P<0.01), however it not significantly related with CD4+content (r=0.074, P>0.05), but than the HMGB1 level in ITP group was directly proportional to CD8+content (r=0.844, P<0.01) and to IL-4 content (r=0.784, P<0.01), and was inversely proportional to IFN-γ level(r=-0.814,P<0.01),and also was inversely proportional to IFN-γ /IL-4 ratio(r=-0.887,P<0.01),and directly proportional to TLR4 expression level(r=0.772,P<0.01).
  
  
  CONCLUSIONS
  The HMGB1 and TLR4 expression levels in ITP patients are higher, and clinical therapy can relieve the disease by targetly control in HMGB1 and TLR4 expression.
authors.affiliation: Department of Hematology and Rheumatism, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Dai
authors.affiliation: Department of Hematology and Rheumatism, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China.
authors.forename: Wen-Qian
authors.initials: WQ
authors.lastname: Li
authors.affiliation: Department of Hematology and Rheumatism, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Li
authors.affiliation: Department of Hematology and Rheumatism, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China. E-mail:fjmok@sohu.com.
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Feng
mesh_terms: D015496:CD4-Positive T-Lymphocytes; D005434:Flow Cytometry; D024243:HMGB1 Protein; D006801:Humans; D007371:Interferon-gamma; D015847:Interleukin-4; D010949:Plasma; D016553:Purpura, Thrombocytopenic, Idiopathic; D012333:RNA, Messenger; D013921:Thrombocytopenia; D051197:Toll-Like Receptor 4
chemical_list: D024243:HMGB1 Protein; C508598:IL4 protein, human; D012333:RNA, Messenger; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D015847:Interleukin-4; D007371:Interferon-gamma