Value of vanin-1 assessment in adult patients with primary immune thrombocytopenia

Abstract

The diagnosis of primary immune thrombocytopenia (ITP) is clinical and cannot be established by any specific laboratory assay. Perhaps the best diagnostic study is assessment of the patient's response to ITP therapy. Oxidative stress-related pathways were among the most significant chronic ITP-associated pathways. Overexpression of VNN1 gene, an oxidative stress sensor in epithelial cells, was most strongly associated with progression to chronic ITP. To address this issue, we tested the hypothesis that blood vanin-1 protein level could distinguish between chronic responders and non-responders ITP patients as well as between ITP patients and healthy controls. Vanin-1 protein levels were determined in peripheral blood leukocytes of 80 adult subjects (16 newly diagnosed ITP patients, 24 chronic responders ITP patients, 24 chronic non-responders ITP patients and 16 healthy controls) by enzyme-linked immunesorbent assay (ELISA). Blood vanin-1 protein levels were lower in controls (median = 18.39 ng) than in ITP patients (median = 58.78 ng) with a highly significant p value (p < 0.001). Vanin-1 levels were highly significantly elevated in newly diagnosed ITP patients (median = 188.62 ng) in comparison to chronic responders (median= 26.90 ng) and chronic non-responders (median = 73.87 ng). Vanin-1 level at a cut-off value of >20.73 ng was found to be 100% sensitive and 93.7% specific in discriminating between newly diagnosed ITP patients and healthy controls. Vanin-1 level was found to be 100% sensitive and 100% specific in differentiating between responders and non-responders with a cut-off value of ≤ 34.5 ng. Our results suggest that vanin-1 can distinguish between chronic responders and non-responders ITP patients as well as between newly diagnosed ITP patients and healthy controls. These findings demonstrate that vanin-1 may contribute to the pathogenesis of ITP, indicating that vanin-1 is an important target for further investigation.

Study of Interleukin-33 in Idiopathic Thrombocytopenic Purpura in Children

“…A total of 20 patients with ITP at the onset stage, 40 patients with chronic ITP, and 30 healthy matched controls were enrolled in this study. He found that, 15.6% were males and 84.4% were females, showing a female predominance, with age range of 18-50 years with mean of 31.8 years, which was in agreement with the results of (7,8,9) All these studies were performed on patients with ITP and showed that ITP among adults affects females more than males, with no specific age predominance. On comparing our three groups, we found no statistically significant difference between them.…”

Emerging Concepts in Immune Thrombocytopenia

“…Phosphorylcholine, a CRP ligand present on cell surfaces, was exposed after antibody-induced oxidative stress. Oxidative stress induced by ITP autoantibodies has also been shown in two separate studies on ITP ( 217 , 218 ) and appears to be a suitable biomarker for ITP ( 219 ). Additionally, the pathophysiological role of reactive oxygen species has long been implied in a model of HIV-initiated ITP ( 64 , 65 , 67 ).…”

Proteomic Analysis of Non-depleted Serum Proteins from Bottlenose Dolphins Uncovers a High Vanin-1 Phenotype

“…Despite these highly variable estimates in normal humans, Vanin-1 levels in dolphins appear to be 20–1000 times higher than human. Because reported human serum measurements from the same ELISA manufacturer were incongruent 44 45 with estimates based on proteomic analysis 25 , we performed a product ion scan targeting the homologous human Vanin-1 peptide utilized to measure dolphin Vanin-1 in this study. No signal for the human Vanin-1 peptide was found in normal pooled human serum (data not shown) suggesting human Vanin-1 levels are indeed low and likely to be in the range of ng/ml.…”