The role of nuclear factor kappa B and helicobacter pylori associated protein A in the pathogenesis of idiopathic thrombocytopenic purpura

Abstract

Objective To detect and analyze nuclear factor kappa B (NF-κB), Helicobacter pylori (HP), Helicobacter pylori cytotoxin associated protein A (CagA), platelet (PLT) and platelet associated IgG (PA IgG) in 224 patients with idiopathic thrombocytopenic purpur(ITP) from three urban hospitals of Shaoxing, in order to explore the role of NF-κB and CagA in the pathogenesis of ITP, then to improve the prognosis of ITP. Methods SABC method was used to detect the NF-κB, 13C breath test for the determination of the Hp infection.CagA and PA-IgG were tested by enzyme linked immunosorbent assay.Automatic blood cell analyzer was used to measure PLT.According to the test results, the patients were divided into Hp+ cagA+ NF-κB+ , Hp+ cagA+ NF-κB-, Hp+ cagA-NF-κB+ , Hp+ cagA-NF-κB-, Hp-NF-κB+ , Hp-NF-κB-PLT groups, and PA-IgG, PLT of the six groups were statistically analyzed. Results Of 224 cases with ITP, 175 cases of HP positive, the positive rate was 78.13%.CagA+ 91 cases in 175 cases of Hp+ , accounting for 52%, overall 43.63%.NF-kappa B+ 108 cases, the positive rate was 46.21%, 78 cases were found in Hp+ cagA+ , accounting for 85.71% in cagA+ .In 84 cases of Hp+ cagA-, there were 21 cases NF-κB+ , the positive rate was 25%.In 49 of HP-, 9 cases with NF-kappa B+ , accounting for 18.37%.PLT and PA-IgG were compared among the groups.The count of PLT of group Hp+ , group Hp+ cagA+ and group NF-κB+ was lower than group Hp-, group Hp+ cagA- and group NF-κB-.However, the level of PA-IgG of group Hp+ , group Hp+ cagA+ and group NF-κB+ was higher than group Hp-, group Hp+ cagA- and group NF-κB-, the difference was statistically significant(P<0.05). Conclusion CagA maybe directly or through the activation of NF-kappa B take part in the immune response of ITP, cause PA-IgG increased and thrombocytopenia. Key words: Helicobacter pylori; Cytotoxin-associated protein; Nuclear factor-kappa B; Purpur, thrombocytopenic