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Blood, 1 April 2004, Vol. 103, No. 7, pp. 2645-2647.
Prepublished online as a Blood First Edition Paper on December 11, 2003; DOI 10.1182/blood-2003-07-2268.
Submitted July 7, 2003
Accepted November 11, 2003
Adult chronic idiopathic thrombocytopenic purpura (ITP) is the manifestation of a type-1 polarized immune response
Fotios P Panitsas, Maria Theodoropoulou, Alexandra Kouraklis, Marina Karakantza, Georgios L Theodorou, Nicholas C Zoumbos, Alice Maniatis, and Athanasia Mouzaki*
Medical School, Laboratory Hematology & Transfusion Medicine, University of Patras, Patras, Greece
Medical School & University Hospital, Hematology Division, University of Patras, Patras, Greece
* Corresponding author; email: mouzaki{at}med.upatras.gr.
Derangement of cellular immunity is central in the pathophysiology of adult autoimmune/idiopathic thrombocytopenic purpura (ITP). Herein we investigated cytokine gene expression in peripheral blood mononuclear cells (PBMC) of adult chronic ITP patients, and attempted to correlate cytokine polarization with the degree of thrombocytopenia. We used semi-quantitative RT-PCR to measure the expression of type-1 (IL-2, IFN- ) and type-2 (IL-4,-5,-10,-3,-13) cytokines by PBMC from 21 patients and 11 controls. Plasma TGF- 1 levels were measured by ELISA. Th1/Th2 ([IL-2+IFN-]/[IL-4+IL-5]) cytokine mRNA ratios, thought to reflect the Th deviation of the pathogenic disease-specific T-cells, and type-1/type-2 mRNA ratios, thought to reflect the overall immune response polarization, were significantly increased in ITP patients. The Th1/Th2 ratio was inversely correlated with platelet counts. TGF-1 levels appeared suppressed in patients with active disease, though not significantly. Our findings show a clear type-1 cytokine polarization of the autoimmune response in adult ITP which persists irrespective of disease status.
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