Dolasik Ilhan, Birtas Atesoglu Elif, Tarkun Pinar, Mehtap Ozgur, Keski Hakan, Dogru Atalay, Hacihanefioglu Abdullah
Department of Internal Medicine, Kocaeli University , Kocaeli , Turkey and.
Platelets. 2015;26(3):220-3. doi: 10.3109/09537104.2014.898746. Epub 2014 Apr 21.
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by peripheral thrombocyte destruction. In some autoimmune disorders, heat-shock proteins (HSP) are suggested to be an important antigenic factor. In this study, we demonstrated the serum free levels of HSP60, HSP70, anti-HSP60, and anti-HSP70 in ITP patients and healthy controls. Twenty-eight newly diagnosed ITP patients, 35 ITP patients in chronic phase, and 25 healthy controls were enrolled to this study. Serum levels of HSP60, HSP70, anti-HSP60, and anti-HSP70 were determined by the ELISA method. Serum HSP60 levels of newly diagnosed ITP patients were significantly decreased when compared with both chronic phase ITP patients and healthy controls. HSP60 levels of ITP patients (both newly diagnosed and chronic phase) with thrombocyte counts more than 30 × 10(9)/L were significantly increased compared with ITP patients with thrombocyte counts less than 30 × 10(9)/L and there was a positive correlation between thrombocyte counts and serum free HSP60 levels in ITP patients. This is the first study demonstrating the extracellular HSP levels in adult ITP patients. HSPs are shown to have a place in the pathogenesis of many autoimmune disorders. Low level of HSP60 may lead to lack of anti-inflammatory response due to less Treg activation, hence, could be a counterpart in the pathogenesis of ITP. Further studies are needed to understand the role of HSPs in the pathogenesis of ITP and whether they can be used for diagnosis, prognosis, and treatment of ITP.
免疫性血小板减少症(ITP)是一种以外周血小板破坏为特征的自身免疫性疾病。在一些自身免疫性疾病中,热休克蛋白(HSP)被认为是一种重要的抗原因素。在本研究中,我们检测了ITP患者和健康对照者血清中游离的HSP60、HSP70、抗HSP60和抗HSP70水平。28例新诊断的ITP患者、35例慢性期ITP患者和25例健康对照者纳入本研究。采用ELISA法测定血清中HSP60、HSP70、抗HSP60和抗HSP70水平。新诊断的ITP患者血清HSP60水平与慢性期ITP患者和健康对照者相比均显著降低。血小板计数大于30×10⁹/L的ITP患者(新诊断和慢性期)的HSP60水平较血小板计数小于30×10⁹/L的ITP患者显著升高,且ITP患者血小板计数与血清游离HSP60水平呈正相关。这是第一项证明成年ITP患者细胞外HSP水平的研究。HSP在许多自身免疫性疾病的发病机制中占有一席之地。低水平的HSP60可能由于Treg激活减少而导致抗炎反应不足,因此可能是ITP发病机制中的一个因素。需要进一步研究以了解HSP在ITP发病机制中的作用以及它们是否可用于ITP的诊断、预后和治疗。