title: Cytokine profile of patients with chronic immune thrombocytopenia affects platelet count recovery after Helicobacter pylori eradication.
abstract: Helicobacter pylori eradication induces platelet recovery in a subgroup of patients with chronic immune thrombocytopenia (cITP), but the mechanisms involved are still not understood. We aimed to evaluate the effect of H. pylori eradication on platelet response and to identify the associated serum cytokine profile in 95 patients with cITP. Serum cytokine concentrations were determined by enzyme-linked immunosorbent assay prior to and 6 months after H. pylori eradication. Remission of cITP was observed in 17 (28·8%) of 59 patients in whom the bacterium was eradicated. Six months after treatment, a significant reduction in the concentrations of T-helper (Th) 1 and Th17 cells and an increase in T regulatory (Treg) and Th2-cell commitment cytokines were observed in patients who recovered, but not in those whose platelet count did not recover. Patients who had a platelet response to eradication of the bacteria had higher pre-treatment serum levels of γ-interferon (IFNG, IFN-γ), transforming growth factor-β (TGFB1, TGF-β) and interleukin 17 (IL17A, IL-17) than patients who did not respond, but only higher pre-treatment TGFB1 levels was independently associated with platelet response. In conclusion, amelioration of cITP after eradication of H. pylori was linked to a more efficient suppression of Th1 and Th17 response and a more pronounced Treg cell response.
authors.affiliation: Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Andreia M C
authors.initials: AM
authors.lastname: Rocha
authors.forename: Cláudia
authors.initials: C
authors.lastname: Souza
authors.forename: Fabrício F
authors.initials: FF
authors.lastname: Melo
authors.forename: Nelma C D
authors.initials: NC
authors.lastname: Clementino
authors.forename: Marília C A
authors.initials: MC
authors.lastname: Marino
authors.forename: Gifone A
authors.initials: GA
authors.lastname: Rocha
authors.forename: Dulciene M M
authors.initials: DM
authors.lastname: Queiroz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016207:Cytokines / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000276:immunology* / Q000382:microbiology; D012074:Remission Induction; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D058504:Th17 Cells / Q000276:immunology; D053773:Transforming Growth Factor beta1 / Q000097:blood; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D016207:Cytokines; C508960:TGFB1 protein, human; D053773:Transforming Growth Factor beta1
keywords: Helicobacter pylori; chronic immune thrombocytopenia; cytokine