Evaluation of IVIG response in relation to Th1/Th2 cytokines in pediatricm immune thrombocytopenia

Cytokine. 2019 Aug:120:234-241. doi: 10.1016/j.cyto.2019.05.014. Epub 2019 May 23.

Abstract

Immune thrombocytopenia (ITP) is a common immune-mediated bleeding disorder in children, and intravenous immunoglobulin (IVIG) is widely used as the initial therapy of ITP. Effective predictive factors of response to IVIG in ITP are important for guiding the treatment decisions. A retrospective study was performed on 197 Chinese ITP patients, and the data of their serum interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ) levels, age at onset, duration of disease, white blood cell count (WBC), platelet count, and gender ratio were collected. Our results showed that ITP patients had higher IL-2, IL-6, IL-10, and IFN-γ levels than healthy children. Moreover, lower IL-4 level (<3.5 pg/ml), higher WBC (>6.37*109/L), and higher platelet count (>12 * 109/L) at diagnosis were favorable predictive factors for IVIG response in the newly diagnosed ITP. In addition, ITP patients with lower IL-10 level (<3.7 pg/ml) and older onset age (>2.84 years) were more resistant to therapy and developed to chronic ITP more easily. These findings may help guide the treatment decisions making for ITP patients.

Keywords: Children; Immune thrombocytopenia; Intravenous immunoglobulin; Th1/Th2 Cytokines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Chronic Disease
  • Cytokines / blood*
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Infant
  • Infant, Newborn
  • Leukocyte Count
  • Male
  • Platelet Count
  • Purpura, Thrombocytopenic, Idiopathic / blood*
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy*
  • Th1 Cells / immunology*
  • Th2 Cells / immunology*
  • Treatment Outcome

Substances

  • Cytokines
  • Immunoglobulins, Intravenous