Study of CD4+, CD8+, and natural killer cells (CD16+, CD56+) in children with immune thrombocytopenic purpura

El-Rashedi, Farida H; El-Hawy, Mahmoud A.; Helwa, Mohamed A; Abdallah, Sameh

doi:10.1016/j.hemonc.2017.01.001

Cited by 22 publications

(12 citation statements)

References 31 publications

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“…In our study, we found that NK cells were significantly decreased in active ITP patients than in controls. This was in agreement with Talaat et al [16] and El-Rashedi et al [10]. For ITP patients who had undergone therapy, Garcia-Suarez, et al found that the activity of NK cells was correlated with therapy treatment, meaning that there was an increase in the number of NK cells in ITP patients who were effectively treated [17].…”

Section: Discussionsupporting

confidence: 83%

“…Abnormal T-lymphocyte subpopulations in patients with ITP have been previously reported. Some studies have reported increased CD8+ T lymphocytes and decreased CD4/CD8 ratios [10]. Other reports, however, have indicated normal CD4/CD8 ratios [11][12][13], increased numbers of both CD4+ T and CD8+ T lymphocytes [12,14], or decreased CD8+ T lymphocytes alone in patients with ITP [15].…”

Section: Discussionmentioning

confidence: 99%

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Immune dysregulation in primary immune thrombocytopenia patients

Zhang

et al. 2018

Hematology

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ITP patients presented with a high CD4/CD8 ratio and low levels of Tregs and NK cells, suggesting that immune deregulation was involved in the pathogenesis of ITP. The pre-treated immune status of ITP patients may not be related to the curative effect. Tregs significantly increased in the effective group post-treatment, highlighting that the mechanism of restoring Tregs may be involved in the treatment of ITP. However, whether or not the targeted regulation of Tregs is an effective treatment for ITP still requires further studies.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Immune dysregulation in primary immune thrombocytopenia patients

Zhang

et al. 2018

Hematology

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“…The CD3 − CD56 + NK cells count was diminished in the UT‐ITP and NR‐ITP groups. El‐Rashedi et al () also observed a significant reduction in the percentage of NK cells in patients with ITP compared with healthy controls, with a maximum reduction in the acute form of the disease. Conversely, Garcia‐Suarez et al () reported increased CD3 − CD56 + NK cells in ITP patients, particularly in those refractory to therapeutic treatments.…”

Section: Discussionmentioning

confidence: 90%

Platelet and immune characteristics of immune thrombocytopaenia patients non‐responsive to therapy reveal severe immune dysregulation

et al. 2020

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Summary Multifactorial mechanisms leading to diminished platelet counts in immune thrombocytopaenia (ITP) might condition the ability of patients with ITP to respond to treatments. Examining their platelet and immune features, we aimed to detect singular characteristics of patients with ITP who do not respond to any treatment. We studied patients with chronic primary ITP who had been without treatment, or untreated (UT‐ITP), for at least six months; included were responders to agonists of thrombopoietin receptors (TPO‐RA), patients who showed no response to first‐ and second‐line treatments (NR‐ITP), and healthy controls. Platelets from NR‐ITP patients exposed a reduced amount of sialic acid residues. Increased loss of platelet surface sialic acid residues was associated with increased platelet apoptosis. NR‐ITP patients had an increased fraction of naive lymphocyte (L) B cells and a reduced LTreg (Lymphocyte T‐regulator) subset. They also presented an anomalous monocyte and NK (Natural Killer) cells distribution. TPO‐RA‐treated patients seemed to recover an immune homeostasis similar to healthy controls. In conclusion, our results indicate a severe deregulation of the immune system of NR‐ITP. The inverse correlation between loss of sialic acid and LTreg count suggests a potential relationship between glycan composition on the platelet surface and immune response, positing terminal sugar moieties of the glycan chains as aetiopathogenic agents in ITP.

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“…38 Subsequently, Ebbo et al 39 demonstrated that NK cytotoxicity was also suppressed in spleen cells from patients with ITP. More recently, El-Rashedi et al 40 examined NK cells in children with ITP and concluded that childhood ITP is associated with an increase in cytotoxic T lymphocytes, but a decrease in peripheral blood NK cells. The reasons for these observations are unclear, particularly since patients with ITP have elevated levels of interferon-g which is predominantly produced by NK cells.…”

Section: Nk and T Lymphocyte Dysregulationmentioning

confidence: 99%

Recent advances in the mechanisms and treatment of immune thrombocytopenia

Semple

2022

eBioMedicine

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Primary immune thrombocytopenia is an autoimmune disease associated with a reduced peripheral blood platelet count. The phenotype is variable with some patients suffering no bleeding whilst others have severe bleeding which may be fatal. Variability in clinical behaviour and treatment responses reflects its complex underlying pathophysiology. Historically the management has relied heavily on immune suppression. Recent studies have shown that the older empirical immune suppressants fail to alter the natural history of the disease and are associated with a poor quality of life for patients. Newer treatments, such as the thrombopoietin receptor agonists, have transformed ITP care. They have high efficacy, are well tolerated and improve patients' quality of life. A greater understanding of the underlying pathophysiology of this disorder has helped develop a number of new targeted therapies. These include inhibitors of the neonatal Fc receptor inhibitors, Bruton tyrosine kinase and complement pathway. Here we discuss the mechanisms underlying ITP and the new approach to ITP care.

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Study of CD4+, CD8+, and natural killer cells (CD16+, CD56+) in children with immune thrombocytopenic purpura

Abstract: ITP is associated with immunity dysfunction denoted by the increase in cytotoxic T lymphocytes and the decrease in natural killer cells.

Cited by 22 publications

References 31 publications

Immune dysregulation in primary immune thrombocytopenia patients

Immune dysregulation in primary immune thrombocytopenia patients

Platelet and immune characteristics of immune thrombocytopaenia patients non‐responsive to therapy reveal severe immune dysregulation

Recent advances in the mechanisms and treatment of immune thrombocytopenia

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