title: Thrombopoietic cytokines in patients with hepatitis C virus-associated immune thrombocytopenia.
abstract: OBJECTIVE
  Complex and multiple mechanisms are involved in the etiology of Hepatitis C virus-associated immune thrombocytopenia (HCV-ITP). Many hematopoietic growth factors affect the thrombopoiesis. The aim of this study was to clarify the interaction of the thrombopoietic factors in patients with HCV-ITP.
  
  
  METHODS
  We selected 33 patients with HCV-ITP and 17 normal individuals. We compare serum interleukin (IL)-3, IL-6, IL-11, thrombopoietin (Tpo), stem cell factor (SCF), granulocyte-macrophage colony-stimulating factor (GM-CSF), tumour necrosis factor-α (TNFα), and spleen size between these two groups.
  
  
  RESULTS
  Our study shows that Tpo, IL-6, and TNFα significantly increased in patients with HCV-ITP compared to the normal population (Tpo:122.577 vs. 40.602; IL-6: 2.175 vs. 0.943; TNFα: 2.460 vs. 1.322). IL-11 was significantly lower in the HCV-ITP group (10.829 vs. 15.042). HCV-ITP patients had a higher spleen index (21.121 vs 13.498, P = 0.003). According to regression analysis and multiple linear regression analysis, only IL-11 had a significantly positive correlation with platelet count, while TNFα showed a negative correlation.
  
  
  CONCLUSIONS
  Tpo and IL-6 increased in patients with HCV-ITP, suggesting a positive feedback of low platelet count. TNFα-associated immune response is suspected to have an impact on low platelet count. IL-11 is assumed to directly affect thrombopoiesis.
  
  
  CONCLUSIONS
  This study is the most comprehensive study to evaluate the interaction between platelet count and the important thrombopoetic factors in patients with HCV-ITP. The thrombopoietic factors clearly play an important role in HCV-ITP.
authors.affiliation: a Division of Hematology and Oncology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.
authors.forename: Cih-En
authors.initials: CE
authors.lastname: Huang
authors.affiliation: a Division of Hematology and Oncology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.
authors.forename: Yi-Yang
authors.initials: YY
authors.lastname: Chen
authors.affiliation: b Division of Cardiology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.
authors.forename: Jung-Jung
authors.initials: JJ
authors.lastname: Chang
authors.affiliation: a Division of Hematology and Oncology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.
authors.forename: Feng-Che
authors.initials: FC
authors.lastname: Kuan
authors.affiliation: a Division of Hematology and Oncology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.|c College of Medicine , Chang Gung University , Tao-Yuan , Taiwan.
authors.forename: Kuan-Der
authors.initials: KD
authors.lastname: Lee
authors.affiliation: a Division of Hematology and Oncology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.|d Graduate Institute of Clinical Medical Sciences, Chang Gung University , Tao-Yuan , Taiwan.
authors.forename: Chang-Hsien
authors.initials: CH
authors.lastname: Lu
authors.affiliation: e Division of Pulmonary and Critical Care Medicine , Chang Gung Memorial Hospital , Chia-yi , Taiwan.
authors.forename: Jrhau
authors.initials: J
authors.lastname: Lung
authors.affiliation: f Division of Gastroenterology, Department of Medicine , Chang Gung Memorial Hospital , Chia-yi , Taiwan.
authors.forename: Chien-Heng
authors.initials: CH
authors.lastname: Shen
authors.affiliation: a Division of Hematology and Oncology , Chang Gung Memorial Hospital , Chia-yi , Taiwan.|c College of Medicine , Chang Gung University , Tao-Yuan , Taiwan.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016174:Hepacivirus / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D013926:Thrombopoietin / Q000097:blood*
chemical_list: D013926:Thrombopoietin
keywords: Cytokine; Hepatitis C; Immune thrombocytopenia; Interleukin; Spleen; Thrombopoietin