OBJECTIVETo investigate the effects of plasma HMGB1, IFN-γ, IL-4 and CD4T cell surface TLR4 expression on the immune thrombocytopenia(ITP).

METHODSTwenty-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 CD4cells. The relatienship between different parameters was analyzed.

RESULTSBefore 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 CD3content (r=0.824, P<0.01), however it not significantly related with CD4content (r=0.074, P>0.05), but than the HMGB1 level in ITP group was directly proportional to CD8content (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).

CONCLUSIONThe 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.