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

Abstract

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.

Association of IL-17A and IL-17F Gene Polymorphisms with Acute Immune Thrombocytopenia in Egyptian Children

“…with the exception of the IL17A rs2275913 GG genotype being more closely associated with early recovery than with a persistent course of the disease (21.7% vs. 5.3%, p = 0.04). Open Journal of Blood Diseases Moreover, El Husseiny et al [23] found that IL-17 levels increased with increased Th17 cells in patients with acute ITP, which is in accordance with other studies [24] [25], and IL-17 has been shown to be down regulated following immunosuppressive therapy [25]. Furthermore, Okamoto et al [26] demonstrated that the response to Eltrombopag, a drug used for thrombocytopenia, is significantly better in patients with low IL-17 expression, indicating that patients with ITP who achieve early remission may have low IL-17 levels [26].…”

T helper 17 cells and interleukin-17 contribute to the pathogenesis of primary immune thrombocytopenia in Egyptian children: a single center experience.

“…Ye et al [11] observed no statistical difference in plasma levels IL -17 between the group with new diagnosis and the group with relapsed ITP. El Husseiny et al [15] in their study of 45 patients with chronic and persistent ITP found significantly higher levels of IL -17 in their patients compared to the control group ( 0.42 versus 0.15, p < 0.001). Our results can be explained by the clinical differences between newly diagnosed and chronic ITP, suggesting the existence of different pathophysiological mechanisms in the two forms In our study, a significant negative correlation was observed between serum levels IL -17 and patient age (r = -0.3, p = 0.03) (Figure 2).…”

“…Very few studies investigated the association between serum levels IL -17 and demographic, clinical or laboratory parameters in childhood ITP Ma et al [13] found no significant association between plasma levels IL -17 and age, sex or platelet count. El Husseiny et al [15] observed an insignificant correlation between IL -17 and platelet count Okamoto et al [16] divided their patients into IL -17-low expression and IL -17-high expression group. The clinical information between the IL -17-low-expression group and the IL -17-highexpression group did not differ significantly in terms of age, sex, and platelet count.…”

Interleukin-17 Serum Level and Its Prognostic Significance in Children with Immune Thrombocytopenia

“…Ma et al (13) found no significant association between plasma IL-17 levels and any of age, sex or platelet counts. El Husseiny et al (14) observed insignificant correlation between IL-17 levels and platelet counts.…”