IL-23/Th17 pathway and IL-17A gene polymorphism in Egyptian children with immune thrombocytopenic purpura

Ahlam M Ismail,Hanan M Nomeir,Naglaa M Farag,Aliaa M Higazi

doi:10.1186/s13052-021-01131-3

Ahlam M Ismail, Hanan M Nomeir + Show 2 more

Open Access

https://doi.org/10.1186/s13052-021-01131-3

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Abstract

BackgroundImmune thrombocytopenic purpura (ITP) is an acquired complex autoimmune thrombocytopenia. Uncontrolled cellular immune response is one of the key triggers for the loss of immune tolerance in ITP patients. The purpose of this study was to investigate the association of IL-23/Th17, IL-17A and IL-17A rs2275913 gene polymorphism with ITP in Egyptian children.Methods60 patients with ITP and 50 healthy control children from Minia city- Egypt were involved. Serum levels of IL-23 and IL-17A were determined by enzyme-linked immunosorbent assay. The frequency of Th17 cells was measured using flow cytometer. Genotyping for IL-17A was performed via polymerase chain reaction-restriction fragment length polymorphism.ResultsComparing children with ITP to controls, serum levels of IL-23 and IL-17A as well as Th17 cells percentage were significantly increased (p < 0.001). Also, higher levels of these ILs and Th17 cells percentage were associated with decreased platelet count within ITP patients (p < 0.001). Analysis of genotype frequencies for IL-17A rs2275913 polymorphism and its alleles (A, G) showed no significant difference between cases and controls. Likewise, no significant differences were demonstrated between acute and chronic ITP regarding both IL-17A rs2275913 polymorphism prevalence and levels of IL-23, IL-17A plus Th17 cells percentage. The frequency of A alleles was 85 and 86% within patients and controls, respectively.ConclusionsElevated levels of IL-23, IL-17A and Th17 cells may be involved in ITP pathogenesis while IL-17A polymorphism rs2275913 is not prevalent in Egyptian children with ITP.

Highlights

Immune thrombocytopenic purpura (ITP) is an acquired complex autoimmune thrombocytopenia
Statistically significant lower platelet count and hemoglobin concentration along with higher Mean platelet volume (MPV), T helper 17 (Th17) cells percentage, and serum levels of IL-23 and IL-17A were detected in ITP patients (Table 1)
Regarding Th17, IL-23 and IL-17A, we found no statistically significant difference in their levels in chronic ITP patients when compared with those with acute ITP (Table 2)

Summary

Introduction

Immune thrombocytopenic purpura (ITP) is an acquired complex autoimmune thrombocytopenia. Uncontrolled cellular immune response is one of the key triggers for the loss of immune tolerance in ITP patients. Immune thrombocytopenic purpura (ITP) is a common acquired autoimmune thrombocytopenic syndrome in children. It is characterized by immune-mediated platelet destruction due to binding of immunoglobulin (Ig) G autoantibodies with platelet glycoproteins (GPs) mostly GPIIb/IIIa and GPIb/IX [1]. ITP patients have platelet autoreactive B cells but T cells immune abnormalities and cytokine imbalance are involved as well [5]. In this way, excessive stimulation of cytotoxic T-lymphocytes induces autologous platelets destruction [6].

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