Division of Hematology-Oncology, Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Clin Exp Med. 2022 Nov;22(4):595-603. doi: 10.1007/s10238-022-00790-8. Epub 2022 Feb 8.
Both platelet count and function change after treatment of immune thrombocytopenia. Platelet function can be measured by plasma markers, including platelet activity [e.g., soluble P-selectin (sP-selectin) and soluble CD40 ligand (sCD40L)] and platelet turnover markers [e.g., glycocalicin (GC)]. Patients were classified into no response (NR, including new diagnosis), partial response (PR) and complete response (CR). One hundred and sixteen samples (29 CR, 32 PR, 55 NR) from 79 patients were collected. Plasma markers (sP-selectin, sCD40L and GC) were measured by ELISA. Platelet counts and mean platelet volume (MPV) were obtained in the clinical laboratory using GenS System-2. The results showed that responsive patients (PR + CR) had higher levels of sP-selectin (P = 0.026) and sCD40L (P = 0.001). Although there was no difference in MPV (P = 0.077) or GC (P = 0.078), there was a marked decrease of GC index (P < 0.001) in responsive patients. Paired sample analysis showed no difference in sP-selectin, sCD40L, MPV or GC but significant difference in GC index (P = 0.017) between NR and PR. Another paired sample analysis showed no difference in sP-selectin, sCD40L, MPV or GC but significant difference in GC index (P = 0.029) between PR and CR. Patients with refractory and newly diagnosed disease had a significant difference in GC (P = 0.020) and sCD40L (P = 0.001), despite similarly low platelet counts. In conclusion, platelet activity markers (sP-selectin and sCD40L) and GC indices change in parallel with treatment response. Plasma levels of GC and sCD40L may be predictors of treatment response.
血小板计数和功能在免疫性血小板减少症治疗后发生变化。血小板功能可以通过血浆标志物进行测量，包括血小板活性[例如，可溶性 P-选择素（sP-选择素）和可溶性 CD40 配体（sCD40L）]和血小板更新标志物[例如，糖蛋白 Ib（GC）]。患者分为无反应（NR，包括新诊断）、部分反应（PR）和完全反应（CR）。从 79 名患者中收集了 116 个样本（29 个 CR、32 个 PR、55 个 NR）。通过 ELISA 测量血浆标志物（sP-选择素、sCD40L 和 GC）。使用 GenS System-2 在临床实验室中获得血小板计数和平均血小板体积（MPV）。结果显示，有反应的患者（PR+CR）的 sP-选择素水平更高（P=0.026）和 sCD40L（P=0.001）。尽管 MPV（P=0.077）或 GC（P=0.078）没有差异，但有反应的患者的 GC 指数明显下降（P<0.001）。配对样本分析显示，NR 和 PR 之间的 sP-选择素、sCD40L、MPV 或 GC 没有差异，但 GC 指数有显著差异（P=0.017）。另一个配对样本分析显示，PR 和 CR 之间的 sP-选择素、sCD40L、MPV 或 GC 没有差异，但 GC 指数有显著差异（P=0.029）。尽管血小板计数相似，但难治性和新诊断疾病患者的 GC（P=0.020）和 sCD40L（P=0.001）存在显著差异。总之，血小板活性标志物（sP-选择素和 sCD40L）和 GC 指数随治疗反应而变化。GC 和 sCD40L 的血浆水平可能是治疗反应的预测因子。
