title: Adult chronic idiopathic thrombocytopenic purpura (ITP) is the manifestation of a type-1 polarized immune response.
abstract: Derangement of cellular immunity is central in the pathophysiology of adult autoimmune/idiopathic thrombocytopenic purpura (ITP). Herein we investigated cytokine gene expression in peripheral blood mononuclear cells (PBMCs) of adult chronic ITP patients and attempted to correlate cytokine polarization with the degree of thrombocytopenia. We used semiquantitative reverse-transcriptase-polymerase chain reaction (RT-PCR) to measure the expression of type-1 (interleukin-2 [IL-2], interferon gamma [IFN-gamma]) and type-2 (IL-4, IL-5, IL-10, IL-3, IL-13) cytokines by PBMCs from 21 patients and 11 controls. Plasma transforming growth factor beta1 (TGF-beta1) levels were measured by enzyme-linked immunoassay (ELISA). T helper 1 (Th1)/Th2 ([IL-2 + IFN-gamma]/[IL-4 + IL-5]) cytokine mRNA ratios, thought to reflect the Th deviation of the pathogenic disease-specific T cells, and type-1/type-2 mRNA ratios, thought to reflect the overall immune response polarization, were significantly increased in ITP patients. The Th1/Th2 ratio was inversely correlated with platelet counts. TGF-beta1 levels appeared suppressed in patients with active disease, though not significantly. Our findings show a clear type-1 cytokine polarization of the autoimmune response in adult ITP that persists irrespective of disease status.
authors.affiliation: Laboratory Hematology and Transfusion Medicine, Medical School, University of Patras, Greece.
authors.forename: Fotios P
authors.initials: FP
authors.lastname: Panitsas
authors.forename: Maria
authors.initials: M
authors.lastname: Theodoropoulou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kouraklis
authors.forename: Marina
authors.initials: M
authors.lastname: Karakantza
authors.forename: Georgios L
authors.initials: GL
authors.lastname: Theodorou
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Zoumbos
authors.forename: Alice
authors.initials: A
authors.lastname: Maniatis
authors.forename: Athanasia
authors.initials: A
authors.lastname: Mouzaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002478:Cells, Cultured; D016207:Cytokines / Q000097:blood / Q000235:genetics*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood / Q000235:genetics; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000235:genetics / Q000276:immunology*; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D016207:Cytokines; D007378:Interleukins