title: High Th1/Th2 ratio in patients with chronic idiopathic thrombocytopenic purpura.
abstract: Chronic immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by increased platelet clearance because of antiplatelet antibodies. It was recently reported that the balance of T helper 1 (Th1) and T helper 2 (Th2) subsets has been implicated in the regulation of many immune responses. In this study, the intracellular interleukin-4 and interferon-gamma production in CD4+ T-lymphocytes activated by phorbol 12-myristate 13-acetate and ionomycin was assessed via flow cytometry in order to determine the clinical significance of the Th1/Th2 ratio in 42 patients with ITP. The study cohort included 28 untreated patients, seven postprednisolone therapy patients and seven postsplenectomy patients. The mean level of the Th1/Th2 ratio in the untreated group was 36.9 (95% CI 25.8-47.9), and significantly higher than in the control group (mean 12.8, 95% CI 9.5-16.1). The mean levels of the Th1/Th2 ratio in the postprednisolone therapy and postsplenectomy groups were 20.5 (95% CI 8.4-32.6) and 16.4 (95% CI 3.1-29.7), respectively, but were no significant differences as compared with control subjects. When untreated patients were divided into two subgroups by Th1/Th2 ratio, the mean level of platelet associated IgG in the high Th1/Th2 subgroup (higher than upper limit of control group) tended to be higher than in the normal Th1/Th2 subgroup. In conclusion, the high Th1/Th2 ratio was closely related to the etiology and disease status of chronic ITP.
authors.affiliation: Department of Laboratory Sciences, Gunma University School of Health Sciences, Maebashi, Gunma, Japan. ogawara@health.gunma-u.ac.jp
authors.forename: Hatsue
authors.initials: H
authors.lastname: Ogawara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.forename: Kimio
authors.initials: K
authors.lastname: Morita
authors.forename: Masaki
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Junko
authors.initials: J
authors.lastname: Kojima
authors.forename: Hatsuo
authors.initials: H
authors.lastname: Amagai
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tsumita
authors.forename: Yoriaki
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsukamoto
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nojima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murakami
mesh_terms: D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015759:Ionomycin / Q000494:pharmacology; D007476:Ionophores / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000494:pharmacology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000276:immunology; D013755:Tetradecanoylphorbol Acetate; D018417:Th1 Cells / Q000166:cytology*; D018418:Th2 Cells / Q000166:cytology*; D013997:Time Factors
chemical_list: D016207:Cytokines; D007074:Immunoglobulin G; D007476:Ionophores; D015759:Ionomycin; D011239:Prednisolone; D013755:Tetradecanoylphorbol Acetate