Abstract
Primary immune thrombocytopenia (ITP) is characterized with decreased platelet count and increased risk of bleeding. The mechanism of thrombocytopenia in ITP is incompletely understood but thought to involve autoantibodies which are produced by the B cells and are stimulated by helper T cells. Regulatory T cells (Treg) have been seen to be significant in ITP pathogenesis. Recent studies have reported reduction of circulating Treg cells in ITP patients but similar levels with controls have also been observed. The ectoenzyme CD39 is highly expressed on the surface of Treg cells and can suggest its immunosuppressive function.In this study we aimed to analyze CD4+CD39+ T lymphocytes both in the blood and spleen of patients with ITP who did not respond to the first line treatment and underwent splenectomy as a second line therapy. Non-ITP patients undergoing splenectomy were involved in the control group. Our data demonstrates significant diminution of in splenic but not circulating CD4+CD39+ T cells in ITP patients compared to controls. Of note, the comparison of spleen and peripheral CD4+CD39+T lymphocytes indicates that the frequency of CD39+ Treg cells is more stable in spleen compared to blood in ITP patients. Our data suggests the potential of CD39 as an important biomarker for ITP and underlines the clinical and scientific value of spleen immune analyzes in this pathology.
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