Lymphocyte subpopulations: a potential predictor of a response in patients with immune thrombocytopenia.
| Autor: | Žibřidová K; 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Academic Department of Internal Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic., Souček O; Department of Clinical Immunology and Allergology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic., Krčmová LK; Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic., Jankovičová K; Department of Clinical Immunology and Allergology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic., Gančarčíková M; Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic., Pejková MA; 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Academic Department of Internal Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic., Drugda J; 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Academic Department of Internal Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic., Nováková D; 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Academic Department of Internal Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic., Košťál M; 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Academic Department of Internal Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic. |
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| Jazyk: | angličtina |
| Zdroj: | Hematology (Amsterdam, Netherlands) [Hematology] 2024 Dec; Vol. 29 (1), pp. 2304486. Date of Electronic Publication: 2024 Jan 22. |
| DOI: | 10.1080/16078454.2024.2304486 |
| Abstrakt: | Objectives: Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by increased platelet destruction and altered production. Despite the well-described pathophysiological background of immune dysregulation, current treatment guidelines consist of monotherapy with different drugs, with no tool to predict which patient is more suitable for each therapeutic modality. Methods: In our study, we attempted to determine differences in the immune setting, comparing the patients' responses to administered therapy. During 12-month follow-up, we assessed blood count, antiplatelet autoantibodies, and T lymphocyte subsets in peripheral blood in 35 patients with ITP (newly diagnosed or relapsed disease). Results: Our data show that the value of antiplatelet autoantibodies, the percentage of cytotoxic T lymphocytes, and the immunoregulatory index (IRI, CD4+ / CD8+ T cell ratio) differ significantly by treatment response. Responders have a higher IRI (median 2.1 vs. 1.5 in non-responders, P = 0.04), higher antiplatelet autoantibodies (median 58 vs. 20% in non-responders, P = 0.01) and lower relative CD8+ T cells count ( P = 0.02) before treatment. Discussion: The results suggest that immunological parameters (antiplatelet autoantibodies, relative CD8+ T cell count and IRI) could be used as prognostic tools for a worse clinical outcome in patients with ITP. Conclusion: These biomarkers could be utilized for stratification and eventually selection of treatment preferring combination therapy. |
| Databáze: | MEDLINE |
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