Yahia Sohier, Eldars Waleed, Eldegla Heba, Mansour Ahmed K, Guaida Mouna, Abdelkader Mohamed S A, Wahba Yahya
Pediatric Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Department of Medical Microbiology and Immunology, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Indian J Hematol Blood Transfus. 2023 Oct;39(4):635-641. doi: 10.1007/s12288-023-01639-0. Epub 2023 Feb 25.
Immune thrombocytopenic purpura (ITP) is an autoimmune disease with possible dysregulation of the apoptotic pathways. We aimed to evaluate the possible role of some apoptotic markers (caspase 3, caspase 8 and BCL2) in the pathogenesis and course of ITP. We investigated some apoptotic markers (caspase 3, caspase 8 and BCL2) using the flow cytometry in 60 children with newly diagnosed ITP, 20 children with chemotherapy-related thrombocytopenia (CRT) and 20 healthy children. We also assessed the effects of intravenous immunoglobulin (IVIG) and methyl prednisolone therapies on the platelet apoptosis in children with newly diagnosed ITP. We demonstrated significantly higher values of caspase 3 in the newly diagnosed ITP group than control and CRT groups, and non-significantly higher values of caspase 8 in the ITP group than the healthy group. After IVIG treatment, the platelet count increased in all patients, and there was a significant decrease in caspase 3 and caspase 8 levels while BCL2 level increased. Regarding methylprednisolone treatment, there was a significant decrease in BCL2 and caspase 8 levels while caspase 3 levels did not significantly decrease. There is a possible role of the caspase dependent cell death pathway of the platelets in the occurrence of newly diagnosed ITP. There is heterogeneity in the apoptotic changes of newly diagnosed ITP children who received IVIG versus those who received methylprednisolone.
免疫性血小板减少性紫癜(ITP)是一种自身免疫性疾病,可能存在凋亡途径失调。我们旨在评估某些凋亡标志物(半胱天冬酶3、半胱天冬酶8和BCL2)在ITP发病机制和病程中的可能作用。我们使用流式细胞术对60例新诊断的ITP患儿、20例化疗相关血小板减少症(CRT)患儿和20例健康儿童进行了一些凋亡标志物(半胱天冬酶3、半胱天冬酶8和BCL2)的研究。我们还评估了静脉注射免疫球蛋白(IVIG)和甲泼尼龙疗法对新诊断的ITP患儿血小板凋亡的影响。我们发现,新诊断的ITP组中半胱天冬酶3的值显著高于对照组和CRT组,ITP组中半胱天冬酶8的值高于健康组,但差异不显著。IVIG治疗后,所有患者的血小板计数均升高,半胱天冬酶3和半胱天冬酶8水平显著降低,而BCL2水平升高。关于甲泼尼龙治疗,BCL2和半胱天冬酶8水平显著降低,而半胱天冬酶3水平未显著降低。血小板的半胱天冬酶依赖性细胞死亡途径在新诊断的ITP发生中可能起作用。接受IVIG治疗的新诊断ITP患儿与接受甲泼尼龙治疗的患儿在凋亡变化方面存在异质性。
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