Regulatory T-lymphocyte subsets in children with chronic immune thrombocytopenia after high-dose of dexamethasone

Khalid Ibrahim Elsayh; Khaled Saad; Naglaa Samy Osman; Khaled Hashim Mahmoud; Faisal A Ahmad; Shaimaa M Khalaf; Noha G Sayed; Zeinab Albadry M Zahran; Aliaa M A Ghandour; Amira A Elhoufey; Tamer Bedir; Asmaa Zahran

doi:10.1038/s41390-022-01978-0

Regulatory T-lymphocyte subsets in children with chronic immune thrombocytopenia after high-dose of dexamethasone

Pediatr Res. 2022 Nov;92(5):1432-1436. doi: 10.1038/s41390-022-01978-0. Epub 2022 Feb 16.

Affiliations

¹ Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
² Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt. khaled.ali@med.au.edu.eg.
³ Department of clinical pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁴ Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁵ Department of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt.
⁶ Department of Community Health Nursing, Alddrab University College, Jazan University, Jazan, Saudi Arabia.
⁷ Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
⁸ Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

Abstract

Background: Immune thrombocytopenia (ITP) is an acquired autoimmune disease. This study's objective was to estimate the variations in the population of CD4⁺CD25^+High FoxP3⁺ cells (CD4⁺ regulatory T-lymphocytes; Tregs) in previously untreated children with chronic ITP managed in Assiut University Hospitals, as well as to evaluate the efficacy of high-dose dexamethasone (HD-DXM) in these patients.

Methods: In this study, we investigated the frequencies of T-lymphocyte subsets in 27 untreated children with chronic ITP.

Results: Prior to treatment, the percentages of CD4⁺CD25^High cells and Tregs were significantly lower in the chronic ITP group compared to the control group (p = 0.018 and p < 0.0001, respectively). After treatment with HD-DXM, Tregs and platelets were significantly increased in these patients (p < 0.0001 for both).

Conclusions: Our results suggest that Tregs are deficient in children with chronic ITP and that HD-DXM immunosuppressive therapy can restore the levels of these cells.

Impact: CD4⁺CD25^High cells and Tregs were significantly lower in children chronic ITP compared to healthy control. HD-DXM treatment led to significantly increased Tregs and platelets in these patients. Our results suggest that Tregs are deficient in children with chronic ITP and that HD-DXM immunosuppressive therapy can restore the levels of these cells.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Autoimmunity
Child
Dexamethasone / therapeutic use
Humans
Purpura, Thrombocytopenic, Idiopathic* / chemically induced
Purpura, Thrombocytopenic, Idiopathic* / drug therapy
T-Lymphocyte Subsets
T-Lymphocytes, Regulatory

Substances

Dexamethasone