Objective: To explore the levels of regulatory T cells (Tregs) and cytokines IL-35, TGF-β and IL-10 in peripheral blood of hemophilia A(HA) patients with FⅧ inhibitor and their clinical significance.
Methods: 43 HA patients admitted to the Hematology Department of the Affiliated Hospital of North China University of Science and Technology from October 2019 to December 2020 were selected, including 6 cases with FⅧ inhibitor and 37 cases without FⅧ inhibitor. In addition, 20 healthy males who underwent physical examinations were selected as healthy controls. Flow cytometry was used to detect the levels of CD4 + CD25 + CD127 - Tregs in peripheral blood of the HA patients and healthy controls, and ELISA assay was used to detect the expression levels of IL-35, TGF-β and IL-10 in serum, and their differences between different groups were compared.
Results: Compared with the healthy control group, the level of Tregs in HA patients was decreased, and the level of Tregs in the FⅧ inhibitor positive group was the lowest, the difference was statistically significant (P <0.05). There was no significant difference in the expression level of Tregs in HA patients of different severity levels. The serum IL-35, TGF-β, and IL-10 levels in both FⅧ inhibitor negative and positive groups were significantly lower than those in healthy control group, and those in FⅧ inhibitor positive group were significantly lower than those in FⅧ inhibitor negative group (all P <0.05).
Conclusion: The decrease of Tregs, IL-35, TGF-β, and IL-10 levels in HA patients may be related to the formation of FⅧ inhibitors.
题目: 外周血调节性T细胞及细胞因子IL-35、TGF-β和IL-10水平在血友病A抑制物阳性患者中的临床意义.
目的: 探讨外周血调节性T细胞（Treg）及细胞因子IL-35、TGF-β和IL-10在血友病A（HA）抑制物阳性患者中的表达水平及临床意义。.
方法: 选取2019年10月至2020年12月华北理工大学附属医院血液科收治的43例血友病A患者，其中抑制物阳性组6例，抑制物阴性组37例；另外选取20例健康体检男性作为健康对照。应用流式细胞术检测抑制物阳性组、抑制物阴性组和健康对照组外周血CD4 + CD25 + CD127 - Treg细胞的水平，ELISA法检测血清IL-35、TGF-β和IL-10的表达水平，比较上述指标在各组间的差异。.
结果: 与健康对照组相比，血友病A患者Treg细胞水平降低，且抑制物阳性组Treg细胞水平最低，差异具有统计学意义（P <0.05）；Treg细胞表达水平在不同严重程度的患者中未见明显差异；抑制物阴性组和抑制物阳性组血清IL-35、TGF-β、IL-10水平均显著低于健康对照组，且抑制物阳性组显著低于抑制物阴性组（均P <0.05）。.
结论: 血友病A患者Treg细胞、IL-35、TGF-β和IL-10水平的降低可能与抑制物的产生有关。.
Keywords: hemophilia A; FⅧ inhibitor; regulatory T cell; cytokines.