Stressful delivery influences circulating thrombopoietin (TPO) levels in newborns: possible role for cortisol in TPO-mpl binding

Ikeno, Kazuhide; Koike, Kenichi; Takeshita, Akira; Shinjo, Kaori; Higuchi, Tsukasa; Nakabayashi, Tetsuo; Akanuma, Sachiko; Hizume, Kiyoko; Ishiguro, Akira; Ogami, Kinya; Kato, Takashi; Miyazaki, Hiroshi; Ohno, Ryuzo; Komiyama, Atsushi

doi:10.1016/s0378-3782(00)00081-5

Cited by 17 publications

(15 citation statements)

References 26 publications

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“…With complicated delivery or neonatal asphyxia, reduced platelet counts have been shown in non-DS neonates. 23,24 However, none of the infants in our analysis was affected by such perinatal factors. Of more importance, recent genetic studies have shown that there are numerous transcriptional factors in regulation of megakaryocyte differentiation and thrombopoiesis.…”

Section: Discussionmentioning

confidence: 78%

Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down's syndrome

et al. 2009

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Background: The pathogenesis of thrombocytopenia during the neonatal period in Down's syndrome (DS) infants remains unclear.Objective: To elucidate kinetic changes of serum thrombopoietin (TPO) level and platelet count, and their correlation in DS neonates.Study Design: Twelve DS infants (male/female: 7/5, term/late preterm: 10/2) born between 1997 and 2007 were included. Blood samples were serially collected during the neonatal period and serum TPO levels were determined in 44 sera using an enzyme-linked immunosorbent assay.Results: Thrombocytopenia <150 Â 10 9 per liter was observed in seven (58%) patients. In 12 DS patients, the median TPO value showed 2.86 fmol ml -1 on day 0, rose to 4.64 fmol ml -1 on day 2, and thereafter decreased to 4.30 fmol ml -1 on day 5, 2.40 fmol ml -1 on days 11-15, and 1.75 fmol ml -1 on days 28-30. This kinetics parallels that in historical non-DS controls. In 35 pair sample analysis from 11 patients without transient myeloproliferative disease, TPO level inversely correlated with platelet count (r ¼ À0.38, P ¼ 0.023). However, there was no significant difference in TPO concentrations between thrombocytopenic and non-thrombocytopenic DS individuals.Conclusions: This is the first study to describe the relationship between TPO level and platelet count in neonates with DS. Median TPO levels and their kinetic changes in DS neonates are comparable to those in non-DS controls. In contrast to earlier findings in several studies showing higher TPO concentrations in thrombocytopenic non-DS newborns than those in non-thrombocytopenic counterparts, the response of the TPO system to thrombocytopenia in DS during the neonatal period seems suboptimal.

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Section: Discussionmentioning

confidence: 78%

Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down's syndrome

et al. 2009

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“…While three groups described higher Tpo concentrations in cord blood samples of preterm versus term neonates (108,110,113,114), no developmental changes were found by others (41,42,75,76,106,107,112). The nding of signicantly higher Tpo plasma concentrations in cord blood of healthy, vaginally delivered term neonates compared with healthy term neonates delivered by Caesarean section (109) suggests that changes in Tpo concentrations ascribed to development may instead result from labor. A cortisol-induced down-regulation of c-mpl binding sites is suggested as the responsible pathogenic mechanism (109).…”

Section: Thrombopoietin Concentrations In Health and Diseasementioning

confidence: 70%

“…The nding of signicantly higher Tpo plasma concentrations in cord blood of healthy, vaginally delivered term neonates compared with healthy term neonates delivered by Caesarean section (109) suggests that changes in Tpo concentrations ascribed to development may instead result from labor. A cortisol-induced down-regulation of c-mpl binding sites is suggested as the responsible pathogenic mechanism (109).…”

Section: Thrombopoietin Concentrations In Health and Diseasementioning

confidence: 99%

Developmental biology of thrombopoietin in the human fetus and neonate

Dame¹

2002

Acta Paediatrica

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“…There were also no antibodies detected in serum from any of the patients 6 months after the start of treatment in Nomura et al' s study [7]. The concomitant use of prednisone may influence the effect of rhTPO, as cortisol is thought to decrease the TPO-Mpl binding [24].…”

Section: Discussionmentioning

confidence: 87%

Multiple cycles of recombinant human thrombopoietin therapy in a patient with chronic refractory idiopathic thrombocytopenic purpura

Hua

Zou

Wang

et al. 2005

Blood Coagulation &Amp; Fibrinolysis

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We describe a 41-year-old woman with chronic idiopathic thrombocytopenic purpura who received recombinant human thrombopoietin (rhTPO) therapy. rhTPO was administrated subcutaneously at a dosage of 1.0 mug/kg daily for a maximum of 14 days until the platelet count was more than 50 x 10/l. The patient received three cycles (six, 13, and eight doses each) of rhTPO, each initiated when the platelet counts was less than 10 x 10/l. The platelet count increased to above 50 x 10/l on days 5, 11 and 8, and peaked at 456 x 10/l, 130 x 10/l and 82 x 10/l on days 9, 15 and 13 in the three respective cycles, each followed by a gradual decline. The durations of platelet counts at more than 50 x 10/l in the three cycles were 13, 7 and 10 days, respectively. rhTPO was well tolerated with no adverse event observed. Antibodies to rhTPO by enzyme-linked immunosorbent assay were not detected. Our observations suggested that rhTPO could transiently increase the peripheral platelet count in patients with chronic refractory idiopathic thrombocytopenic purpura. The reasons why the peak platelet counts decreased and the duration of response shortened after successive cycles of treatment were unclear.

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Stressful delivery influences circulating thrombopoietin (TPO) levels in newborns: possible role for cortisol in TPO-mpl binding

Cited by 17 publications

References 26 publications

Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down's syndrome

Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down's syndrome

Developmental biology of thrombopoietin in the human fetus and neonate

Multiple cycles of recombinant human thrombopoietin therapy in a patient with chronic refractory idiopathic thrombocytopenic purpura

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