Regulatory and Memory B Lymphocytes in Children With Newly Diagnosed Immune Thrombocytopenia

Abstract

Background: Immune (idiopathic) thrombocytopenic purpura (ITP) is a primary autoimmune disease. It is characterized by a diminished peripheral platelet count (< 100 × 10 9 /L) caused by platelet destruction with an increased risk of mucocutaneous bleeding. The diagnosis of ITP depends on clinical characteristics and the laboratory examinations conducted, as well as the ability to exclude other diseases associated with thrombocytopenia. Antiplatelet autoantibodies are responsible for platelet destruction and probably for inhibition of megakaryopoiesis. B lymphocytes participate in immune responses through production of antibodies, antigen presentation to T cells, and cytokine secretion. The aims of this study were to investigate the levels of Bregs and memory B lymphocytes in newly diagnosed pediatric ITP patients and to correlate their levels with the course of the disease.

Assessment of plasma levels of IL-9 and IL-17 in patients with Immune thrombocytopenia

“…According to TLCs, the present study was in agreement with those of Khalifa et al [8] [2], who also reported no statistically significant difference between ITP patients and controls. However, Fahim and Monir [10] found that the TLC count was significantly higher in ITP patients than in controls; this may have been because of neutrophilia or lymphocytosis that may accompany the disease..…”

“…There was no statistically significant differences among studied and control groups regarding hemoglobin level and total leucocyte count , while platelets was significantly lower in patients group compared to control group Table (1) There were one patient (5.0% ) were asymptomatic at diagnosis , five patients (25.0%) were presented with preceding febrile illness ,nineteen patients(95.0%) had skin manifestation, four patients (20%) had bleeding tendency and non of patients had organomegaly (Table (2).…”

“…It is usually a benign, self-limiting disease in children .The diagnosis of ITP depends on clinical characteristics and the laboratory examinations conducted with exclusion other diseases associated with thrombocytopenia [2].…”

Revolution of Disturbed Bregs and Bmems Lymphocytes Homeostasis in Children With Chronic ITP After High-dose Dexamethasone Rescue Therapy

“…This result is consistent with numerous previous studies that stated the upregulation of B cells in ITP. 11,14,19,20 B cells are the principal creators of antiplatelet antibodies. These cells proliferate into autoantibody-secreting cells under the effects of platelet-specific helper T cells.…”

Lower proportion of CD19+IL-10+ and CD19+CD24+CD27+ but not CD1d+CD5+CD19+CD24+CD27+ IL-10+ B cells in children with autoimmune thyroid diseases

“…Other authors aimed to investigate the linkage between Bregs and immune thrombocytopenic purpura (ITP) in children. They revealed a decreased number of Bregs in the peripheral blood in patients with ITP [25].…”