TY - JOUR
T1 - Quantification of specific T and B cells immunological markers in children with chronic and transient ITP
AU - Levy-Mendelovich, Sarina
AU - Lev, Atar
AU - Aviner, Shraga
AU - Rosenberg, Nurit
AU - Kaplinsky, Caim
AU - Sharon, Nechama
AU - Miskin, Hagit
AU - Dvir, Aviya
AU - Kenet, Gili
AU - Schushan, Irit Eisen
AU - Somech, Raz
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/12
Y1 - 2017/12
N2 - Background: Immune thrombocytopenic purpura (ITP) is characterized by a transient (nonchronic) or permanent (chronic) decline in the number of platelets. Predicting the course of ITP, at the time of diagnosis, is of importance. Here we studied at diagnosis, clinical and immunological parameters in order to distinguish between different courses. The latter included the measure of new B and T cells using quantification of kappa-deleting recombination excision circles (KRECs) and T-cell receptor excision circles (TRECs), respectively. Methods: Blood samples were collected from 44 children with a clinical diagnosis of ITP. Real-time PCR was performed in order to quantify the number of copies of TREC and KREC followed by collection of clinical data from medical files. The children were retrospectively divided into two groups: chronic and nonchronic. Results: Twenty-four patients (54%) were classified as nonchronic ITP and 20 patients (46%) were classified as chronic ITP. We confirmed some clinical parameters (e.g., gender, age) but not others (e.g., preceding infection, level of thrombocytopenia) that distinguish patients with chronic and nonchronic course. While KREC quantification was similar in patients regardless the outcome of their disease, it was significantly higher than the level of controls (P < 0.05). TREC quantification was not different between patients and controls. Conclusions: KREC but not TREC levels are different in patients comparing to controls, pointing to an overreaction of B-cell development as a role in the pathogenesis of ITP. These results may shed more lights on the immune mechanism of ITP.
AB - Background: Immune thrombocytopenic purpura (ITP) is characterized by a transient (nonchronic) or permanent (chronic) decline in the number of platelets. Predicting the course of ITP, at the time of diagnosis, is of importance. Here we studied at diagnosis, clinical and immunological parameters in order to distinguish between different courses. The latter included the measure of new B and T cells using quantification of kappa-deleting recombination excision circles (KRECs) and T-cell receptor excision circles (TRECs), respectively. Methods: Blood samples were collected from 44 children with a clinical diagnosis of ITP. Real-time PCR was performed in order to quantify the number of copies of TREC and KREC followed by collection of clinical data from medical files. The children were retrospectively divided into two groups: chronic and nonchronic. Results: Twenty-four patients (54%) were classified as nonchronic ITP and 20 patients (46%) were classified as chronic ITP. We confirmed some clinical parameters (e.g., gender, age) but not others (e.g., preceding infection, level of thrombocytopenia) that distinguish patients with chronic and nonchronic course. While KREC quantification was similar in patients regardless the outcome of their disease, it was significantly higher than the level of controls (P < 0.05). TREC quantification was not different between patients and controls. Conclusions: KREC but not TREC levels are different in patients comparing to controls, pointing to an overreaction of B-cell development as a role in the pathogenesis of ITP. These results may shed more lights on the immune mechanism of ITP.
KW - ITP
KW - KREC
KW - TREC
KW - chronic course
KW - thrombocytopenic
UR - http://www.scopus.com/inward/record.url?scp=85019622586&partnerID=8YFLogxK
U2 - 10.1002/pbc.26646
DO - 10.1002/pbc.26646
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C2 - 28544224
AN - SCOPUS:85019622586
SN - 1545-5009
VL - 64
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 12
M1 - e26646
ER -