[Clinical study of human cytomegalovirus infection in colony forming unit-megakaryocyte in patients with idiopathic thrombocytopenic purpura].
OBJECTIVE
Idiopathic thrombocytopenic purpura (ITP) is a hemorrhagic disease in children with blood platelets redundant destruction caused by chaotic immunological mechanism. However, some patients with ITP with negative platelet-associated antibody and ineffective adrenal cortical hormone therapy probably have special pathogenesis. It is indicated that the human cytomegalovirus (HCMV) can incubate in haemopoietic stem cell/ancestral cell to inhibit its generation and differentiation. Therefore, the study was designed to investigate HCMV-late mRNA expression in megakaryoblast for the purpose of examining the pathogenesis of ITP and to examine the effectiveness of ganciclovir on ITP.


METHODS
Colony forming unit-megakaryocyte (CFU-MK) of 46 ITP patients with HCMV infection were incubated. Reverse transcription-polymerase chain reaction (RT-PCR) was subsequently used for HCMV-late mRNA detection. Ganciclovir therapy was given to both positive group and negative group for comparison of therapeutic effectiveness.


RESULTS
Nineteen out of 46 CFU-MK culture cell specimens with positive HCMV-DNA by PCR or positive CMV-IgM by enzyme linked immunosorbent assay (ELISA) from serum of peripheral blood showed positive for HCMV-late mRNA. While, the remaining 27 were negative. Sixteen positive responders to ganciclovir therapy were observed amongst those with positive HCMV-DNA. Whereas, only 4 positive responders to ganciclovir therapy were noticed amongst those with negative HCMV-DNA. The curative effectiveness in positive group was significantly higher than that in negative group (P < 0.01).


CONCLUSIONS
HCMV can directly infect CFU-MK, which might be one of the mechanisms responsible for ITP. Ganciclovir is an effective therapy resulting in an increase in thrombocyte in ITP patients whose HCMV-late mRNA was positive in their CFU-MK.
Xiao
Yan
Y
Department of Pediatrics, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Lin
Wen
W
Liu
Qin
Q
Jin
Run-ming
RM
Fei
Hong-bao
HB
D000293:Adolescent; D000914:Antibodies, Viral / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects* / Q000276:immunology; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000235:genetics / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D007223:Infant; D008297:Male; D055016:Megakaryocyte Progenitor Cells / Q000187:drug effects / Q000378:metabolism*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D012333:RNA, Messenger; D012367:RNA, Viral / Q000187:drug effects / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction
D000914:Antibodies, Viral; D000998:Antiviral Agents; D007075:Immunoglobulin M; D012333:RNA, Messenger; D012367:RNA, Viral; D015774:Ganciclovir