Immunological characteristics and effect of cyclosporin in patients with immune thrombocytopenia

Autor: Huaquan Wang, Limin Xing, Rong Fu, Xin He, Zonghong Shao, Ting Wang, Chunyan Liu, Ningyuan Ran
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Microbiology (medical)
Adult
Male
medicine.medical_specialty
Anti-nuclear antibody
CD3+T lymphocytes
immune cell subsets
Clinical Biochemistry
antinuclear antibodies
CD8-Positive T-Lymphocytes
Immune system
immune system diseases
Internal medicine
hemic and lymphatic diseases
medicine
Immunology and Allergy
Humans
Research Articles
Aged
Retrospective Studies
Autoimmune disease
Aged
80 and over
B-Lymphocytes
Purpura
Thrombocytopenic
Idiopathic
Hematology
business.industry
Biochemistry (medical)
Therapeutic effect
Public Health
Environmental and Occupational Health
Autoantibody
Gamma globulin
Middle Aged
medicine.disease
Prognosis
cyclosporin
Killer Cells
Natural
Medical Laboratory Technology
immune thrombocytopenia
Immunology
Cyclosporine
Female
business
CD8
Immunosuppressive Agents
Research Article
Follow-Up Studies
Zdroj: Journal of Clinical Laboratory Analysis
ISSN: 1098-2825
0887-8013
Popis: Objective Immune thrombocytopenia (ITP) is well‐known as an antibody‐mediated autoimmune disease, and it is easy to get response but often turns to relapse or refractory. Cyclosporin is a traditional immunosuppressant and had a good effect on ITP patients. In this paper, we retrospectively analyze the immunological characteristics and therapeutic effect of cyclosporin in 220 patients with ITP. Methods All newly diagnosed ITP patients in the Department of Hematology, Tianjin Medical University General Hospital from June 2018 to December 2020 were enrolled and divided into four groups according to the expression of autoantibodies and the occurrence of prodromal infection. The basic data and immune indexes of ITP patients in each group were collected. The clinical immunological characteristics of patients in each group and the therapeutic effect of cyclosporin in each group were analyzed. Results Multi‐autoantibody ITP patients were more likely to have low serum albumin and high gamma globulin, and the ratio of albumin to globulin decreased. In addition, the level of IgA and IgG increased and the level of complement C3 and C4 decreased more frequently than those in other groups. The number of CD3+T lymphocytes, especially CD3+CD4+T lymphocytes, decreased in ANA+ITP patients. The number of CD16+CD56+NK cells, pDC/DC ratio, and pDC/mDC ratio were higher than those in other groups. The expression of IL‐6 and the proportion of CD19+B lymphocytes increased in two groups of ITP patients with abnormal autoantibodies. The patients of pro‐infected group were more likely to suffer from coagulation disorder. After treatment with cyclosporin, the response rate increased and the 3‐month relapse rate decreased in all ITP patients, and the therapeutic effect of patients with high megakaryocyte number was significantly higher than that of patients with low megakaryocyte number. The impact factors that influence the effect of glucocorticoid and(or) IVIG were the number of CD3+CD8+T lymphocytes, CD4/CD8 cell ratio, and the number of CD19+B lymphocytes. The independent impact factor of cyclosporin therapeutic response rate was the number of CD3+T lymphocytes. Conclusions ITP is a heterogeneous disease, recurrence may occur during or rapidly after treatment. Cyclosporine included treatment can improve the effective rate of ITP and reduce the relapse rate within 3 months. The number of CD3+T lymphocytes was the only impact factor that influence the therapeutic effect of cyclosporin in ITP patients.
We showed clinical characteristics of four subgroups of ITP patients according to immune indexes and proinfection. The patients with autoantibodies usually combined with imbalance of immune cells. Comparing with glucocorticoid and(or) IVIG only treatment, cyclosporin‐included regimen has a higher response rate and lower relapse rate. The number of CD3+T lymphocytes is the independent impact factor that influence the therapeutic effect of cyclosporin.
Databáze: OpenAIRE
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