title: Investigation of megakaryocyte apoptosis in children with acute and chronic idiopathic thrombocytopenic purpura.
abstract: OBJECTIVE
  Although the platelet destruction shows a primary role in the thrombocytopenia of idiopathic thrombocytopenic purpura (ITP), it has been demonstrated that impaired platelet production may also contribute to the severity of thrombocytopenia in ITP. The present study examined megakaryocyte apoptosis in bone marrow aspirates of children with acute and chronic ITP and investigated the role of megakaryocyte apoptosis in ITP pathophysiology.
  
  
  METHODS
  Thirteen children diagnosed with acute ITP and eight children diagnosed with chronic ITP comprised the study group. Ten children, who were hospitalized for scoliosis operation but healthy otherwise, comprised the control group. In all children, megakaryocytes were isolated from the same amount of bone marrow aspirate samples using MACS CD61 MicroBeads (Miltenyl Biotec, Auburn, CA, USA). Megakaryocyte apoptosis was studied with transferase-mediated d-UTP-bitin nick end-labeling method.
  
  
  RESULTS
  Isolated megakaryocyte counts did not differ significantly between acute ITP, chronic ITP and control groups. The percentage of apoptotic megakaryocytes did not differ significantly between acute ITP group and control group and between chronic ITP group and control group. The percentage of apoptotic megakaryocytes in patients with chronic ITP was significantly lower than the patients with acute ITP. There was no correlation between the percentage of apoptotic megakaryocytes and platelet counts of the cases.
  
  
  CONCLUSIONS
  Increased megakaryocytic apoptosis does not play a role in the pathogenesis of dysmegakaryopoiesis and impaired platelet production in children with ITP. Decreased megakaryocyte apoptosis in cases with chronic ITP may be due to suppression of megakaryocyte maturation, as the terminal phase of the megakaryocyte lifespan is characterized by the onset of apoptosis.
authors.affiliation: Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, Balçova, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Uçar
authors.forename: Hale
authors.initials: H
authors.lastname: Oren
authors.forename: Gülersu
authors.initials: G
authors.lastname: Irken
authors.forename: Halil
authors.initials: H
authors.lastname: Ateş
authors.forename: Berna
authors.initials: B
authors.lastname: Atabay
authors.forename: Meral
authors.initials: M
authors.lastname: Türker
authors.forename: Canan
authors.initials: C
authors.lastname: Vergin
authors.forename: Işin
authors.initials: I
authors.lastname: Yaprak
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017209:Apoptosis; D001853:Bone Marrow; D016022:Case-Control Studies; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007223:Infant; D008297:Male; D008533:Megakaryocytes / Q000473:pathology*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology / Q000473:pathology*