Immune thrombocytopenia: serum cytokine levels in children and adults.
BACKGROUND
Immune thrombocytopenia (ITP) is an immune-mediated platelet disorder in which autoantibody-coated platelets are removed from the blood by monocytic phagocytes and there is impaired platelet production. There is a delicate balance of specific cytokine levels, which has an important role in the immune system and is known to be deregulated in autoimmune diseases. This study was designed to investigate the differences in Th cytokine levels between children and adults with newly diagnosed ITP and to compare these profiles to those found in healthy, age-matched controls.


METHODS
The concentration of IL-1alpha, IL-2, IL-3, IL-4, IL-6, IL-10, TNF-alpha, IFN-alpha, and IFN-alpha in serum specimens was analyzed by enzyme-linked immunosorbent assay.


RESULTS
At the time of ITP diagnosis, children showed significantly lower serum levels of interleukin IL-2 and tumor necrosis factor TNF-alpha and higher serum level of IL-3 than healthy controls. Serum level of IL-4 in adult ITP patients was higher than those in control subjects. When compared with adults, children with ITP had lower serum level of IL-4, IL-6 and IFN-alpha, and higher level of IFN-alpha.


CONCLUSIONS
Significant differences in serum cytokine levels between pediatric patients and healthy controls indicate that cytokine disturbances--especially changes in IL-2, IL-3 and TNF-alpha--might be involved in the pathogenesis of newly diagnosed ITP. TNF-alpha is the most informative variable for discrimination between healthy children and those with ITP.
Department of Pediatric Hematology, Oncology, Immunology and Medical Genetics, Clinical Hospital Center Split, Medical School, University of Split, Split, Croatia.
Srđana
S
Culić
Ilza
I
Salamunić
Paško
P
Konjevoda
Slavica
S
Dajak
Jasminka
J
Pavelić
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017523:Croatia; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007223:Infant; D007372:Interferons / Q000097:blood; D007378:Interleukins / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D016207:Cytokines; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D007372:Interferons