免疫细胞表型与免疫性血小板减少症的因果关系:一项两样本孟德尔随机化研究OA

Objective To evaluate the potential causal relationship between immune cell phenotype and immune thrombocytopenia(ITP)using Mendelian randomization(MR)analysis.Methods Genome-wide Asso-ciation Studies(GWAS)summary data were used to analyze the two-sample MR using five methods:inverse variance weighting,MR-Egger,weighted median method,simple model method and weighted model method,and the results were evaluated according to the odds ratio(OR)and 95%confidence interval(95%CI)of the effect indicators.The heterogeneity was evaluated by Cochran's Q and the pleiotropy was evaluated by MR-Egger and MR-Presso,while the stability of the results was assessed by the Leave-one-out method.Results The inverse variance-weighted analysis showed that the risk of ITP was significantly correlated with CD27 on plasma(P=0.048,OR=1.14,95%CI 1.00-1.31),CD38 on CD20-(P=0.040,OR=1.23,95%CI 1.01-1.51),CD24 on IgD+CD38br(P=0.030,OR=1.10,95%CI 1.01-1.20),absolute count of CD25++CD8br cells(P=0.035,OR=1.15,95%CI 1.01-1.32),CX3CR1 on monocyte(P=0.023,OR=1.15,95%CI 1.02-1.30),CX3CR1 on CD14+CD16-monocyte(P=0.022,OR=1.14,95%CI 1.02-1.28),HVEM on CD4+(P=0.002,OR=0.88,95%CI 0.82-0.96),and CD28-CD8dim%T cell(P=0.002,OR=0.82,95%CI 0.72-0.93).Through the heterogeneity test and the pleiotropy test,the results showed no heterogeneity and no pleiotropy.Conclusion The elevated levels of six immune cell phenotypes,including CD27 on plasma,CD38 on CD20-,CD24 on IgD+CD38br,absolute count of CD25++CD8br cells,CX3CR1 on monocyte,and CX3CR1 on CD14+CD16-monocyte,may increase the risk of ITP,and are risk factors for ITP.Elevated levels of two immune cell phenotypes,namely HVEM on CD4+and CD28-CD8dim%T cell,may reduce the risk of ITP,and are protective factors for the occurrence of ITP.