Advances in the pathophysiology of primary immune thrombocytopenia

Perera, María; Garrido, Teresa

doi:10.1080/10245332.2016.1219497

Cited by 56 publications

(61 citation statements)

References 97 publications

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“…[13] The serum levels of TGFβ level was significantly decreased in Li W et al However, after the treatment by immunosuppressive therapy, TGFβ was down-regulated[14] which is not consistent with our results.…”

Section: Discussion:-contrasting

confidence: 53%

Immune Thrombocytopenia. Egyptian Experience With Study of Il-17, Tgfb, Cytokines in Chronic and Persistent Immune Thrombocytopenia Patients.

Husseiny¹,

Sobky²,

Khalaf³

et al. 2018

IJAR

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Background: Autoimmune diseases are characterized by various factors that contribute to a breakdown in self tolerance. In this study we review the demographic features of 150 immune thrombocytopenic Egyptian patients and for cases who were chronic and persistent with negative both autoimmune screen and virology for hepatitis B and C, we measured IL-17 and TGF-β by ELISA. Results: Our results revealed Chronic and persistent cases who fulfilled the criteria for cytokine assay were 45 cases with a mean (± SD) age of 31.60 ± 8.78 years. Thirty two patients were presented by skin manifestations (71.1%).Eight patients presented with mucous bleeding (17.8%) and five patients presented by combined skin and mucous membrane bleeding (11.1%). Comparison between the cases studied and control groups revealed statistically significant lower platelet count in cases rather than the control. While the two measured cytokines were statistically significant higher in cases rather than the control. Correlation between platelet count and the level of cytokines was statistically insignificant. All cases were under treatment by low dose corticosteroid in addition to another immunesuppression medication. Conclusion: the higher expression of Treg cytokines (IL-17 and TGF-B) may be explained by effect of immune suppression use or up regulation of their receptors on Treg cells which have resistance to their activity.

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Section: Discussion:-contrasting

confidence: 53%

Immune Thrombocytopenia. Egyptian Experience With Study of Il-17, Tgfb, Cytokines in Chronic and Persistent Immune Thrombocytopenia Patients.

Husseiny¹,

Sobky²,

Khalaf³

et al. 2018

IJAR

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“…Therefore, PAF and cytokines potentiate each other's effects in vivo to modulate the immune response [39]. The strong associations were found between PAF and IL-6, between PAF and IL-10, between PAF and CRP, revealing the PAF, interacting with IL-6 and IL-10, are jointly responsible for thrombocytopenia [25].…”

Section: Discussionmentioning

confidence: 98%

“…Abbreviations: AUC, areas under curve. [22][23][24][25][26][27][28][29][30] cells [50,51], they may closely related to the platelet destruction. Therefore, we used the levels of cytokines as a stratification variable for EFS, the results showed that cytokine play a significant role in EFS.…”

Section: Discussionmentioning

confidence: 99%

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Serum cytokines and clinical features in patients with fever and thrombocytopenia syndrome

Chen

Lin

Fan

et al. 2019

Clinica Chimica Acta

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A B S T R A C TPurpose: To explore the clinical, microbiological and immunological features of patients with fever and thrombocytopenia. Methods: Patients with unexplained fever and thrombocytopenia were enrolled. Viruses were detected using real-time PCR, and bacteria were measured by culturing methods. Serum cytokines, platelet antibody IgG (PA-IgG) and Helicobacter pylori (HP) were detected using ELISA. Results: Pathogens were detected in 74.68% of patients, which included single fungal/viral/bacterial infection and multiple infection. The pathogens could not be unidentified in 25.32% of cases. Cytokines including Interleukin (IL)-6, IL-10, interferon-γ(IFN-γ), platelet activating factor (PAF) and PA-IgG were significantly higher in patients as compared to healthy controls (P < .01 or P < .05). Principal component analyses extracted four groups of parameters that have a strong positive predicting value, revealing that disease status evaluation would be more accurate if we combined the platelet parameters and inflammatory biomarkers. While event-free survival (EFS) that indicates the time of platelet elevated after therapy was the highest in patients with single bacterial or fungal infection, EFS was affected by the levels of cytokines and PA-IgG. Conclusions: Differences in immune function may be the main factors affecting the prognosis of patients with fever and thrombocytopenia, while treatment based on precise etiological diagnosis is important for therapeutic efficacy.

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“…Rituximab exerts its therapeutic effect in ITP mainly through depletion of pre-plasma B cells, thus decreasing autoantibody production [32]. In addition, rituximab could correct the number and dysfunction of the T-cell compartment in ITP patients [33][34][35]. The reason why ITP patients with ANAs could achieve a higher overall response rate remains unknown.…”

Section: Discussionmentioning

confidence: 99%

The association between antinuclear antibody and response to rituximab treatment in adult patients with primary immune thrombocytopenia

Wang

Lei

et al. 2020

Hematology

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Background: Antinuclear antibodies (ANAs) can be detected in about 30% of patients with primary immune thrombocytopenia (ITP), yet their relationship with treatment response to rituximab remains elusive. Methods: we retrospectively reviewed the clinical records of hospitalized adult ITP patients who were treated with rituximab from three medical centers across China. Rituximab was given intravenously at 100 mg weekly for 4 weeks, or at a single dose of 375 mg/m 2. All included patients had their ANAs tested before rituximab treatment. Results: A total of 287 patients fulfilled the inclusion criteria and were eligible for analysis. ANAs were positive in 98 (34.1%) of the included patients. The incidence of overall response and complete response (CR) in ANA-positive patients was significantly higher than that in ANAnegative patients (overall response: 76.5% vs. 55.0%, P < 0.001; CR: 46.9% vs. 29.1%, P = 0.003). However, sustained response (SR) rates in ANA-positive patients at 6, 12 and 24 months were all lower compared with ANA-negative patients (all P < 0.05). The overall duration of response (DOR) estimated by Kaplan-Meier analysis in ANA-negative patients was greater than that in ANA-positive patients (P < 0.001). Conclusion: ITP patients with positive ANA test were likely to achieve a better initial response to rituximab treatment, while their long-term outcome was unfavorable. Therefore, ANA test could be useful for predicting rituximab response in ITP.

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Advances in the pathophysiology of primary immune thrombocytopenia

Abstract: A better understanding of the immunomodulatory effects of each ITP therapy is needed to best manage the disease.

Cited by 56 publications

References 97 publications

Immune Thrombocytopenia. Egyptian Experience With Study of Il-17, Tgfb, Cytokines in Chronic and Persistent Immune Thrombocytopenia Patients.

Immune Thrombocytopenia. Egyptian Experience With Study of Il-17, Tgfb, Cytokines in Chronic and Persistent Immune Thrombocytopenia Patients.

Serum cytokines and clinical features in patients with fever and thrombocytopenia syndrome

The association between antinuclear antibody and response to rituximab treatment in adult patients with primary immune thrombocytopenia

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