Abstract

Objective:Immune thrombocytopenic purpura (ITP) is an immune-mediated bleeding disorder in which platelets are opsonized by autoantibodies and destroyed by an Fc receptor-mediated phagocytosis by the reticuloendothelial system within the spleen. Autoimmune processes are also considered in the pathogenesis of this disorder. CD4+CD25+FoxP3+ regulatory T (Treg) cells and CD8+CD28- Treg cells have roles in autoimmune diseases. We investigated these regulatory cells in ITP patients.Materials and Methods:We included 22 ITP patients and 16 age-matched healthy subjects. CD4+CD25+FoxP3+ Treg cells and CD8+CD28- cells were investigated by three-color flow cytometry. The ratios of these cell populations to total lymphocytes were calculated. Statistical analysis was carried out with the Mann-Whitney U test.Results:CD4+CD25+ Treg cells were 9.69±3.70% and 12.99±5.58% in patients with ITP and controls, respectively. CD4+CD25highFoxP3+ cells were 27.72±19.74% and 27.55±23.98% in ITP patients and controls, respectively. The percentages of both of these cell types were not statistically significant when compared to the control group.Conclusion:We did not find any differences in ratios of CD4+CD25+FoxP3+ Treg cells or CD8+CD28- T cells in lymphocytes between patients and healthy subjects. We conclude that these circulatory cells are not different in ITP, but further studies are needed to explore the putative roles of these regulatory cells.

Highlights

  • Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder in association with increased platelet destruction and impaired platelet production

  • CD4+CD25+forkhead box P3 (FoxP3)+ regulatory T (Treg) cells and CD8+CD28Treg cells have roles in autoimmune diseases. We investigated these regulatory cells in Immune thrombocytopenic purpura (ITP) patients

  • We did not find any differences in ratios of CD4+CD25+FoxP3+ Treg cells or CD8+CD28- T cells in lymphocytes between patients and healthy subjects

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Summary

Introduction

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder in association with increased platelet destruction and impaired platelet production. It is mediated by IgG antiplatelet autoantibodies in which the targets are platelet membrane glycoproteins (GPs), such as GPIIb/IIIa and GPIb/IX. CD4+CD25+ regulatory T (Treg) cells and CD8+CD28- T lymphocytes have major roles in self-tolerance. To maintain the immune tolerance and to prevent autoimmune disease, CD4+CD25+FoxP3+ Treg cells, CD4+ T cells with high expression of CD25, and transcription factor forkhead box P3 (FoxP3), referred to as FoxP3 regulatory T cells, play an important role. Decreased numbers of Treg cells have been reported in patients with various autoimmune diseases, including ITP, rheumatoid arthritis, and systemic lupus erythematosus [1,2,3,4,5]

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