Lymphocyte subpopulations: a potential predictor of a response in patients with immune thrombocytopenia.

IF 2 4区医学 Q3 HEMATOLOGY

Hematology Pub Date : 2024-12-01 Epub Date: 2024-01-22 DOI:10.1080/16078454.2024.2304486

Kateřina Žibřidová, Ondřej Souček, Lenka Kujovská Krčmová, Karolína Jankovičová, Markéta Gančarčíková, Mária Anna Pejková, Jan Drugda, Denisa Nováková, Milan Košťál

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引用次数: 0

Abstract

Objectives: Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by increased platelet destruction and altered production. Despite the well-described pathophysiological background of immune dysregulation, current treatment guidelines consist of monotherapy with different drugs, with no tool to predict which patient is more suitable for each therapeutic modality.

Methods: In our study, we attempted to determine differences in the immune setting, comparing the patients' responses to administered therapy. During 12-month follow-up, we assessed blood count, antiplatelet autoantibodies, and T lymphocyte subsets in peripheral blood in 35 patients with ITP (newly diagnosed or relapsed disease).

Results: Our data show that the value of antiplatelet autoantibodies, the percentage of cytotoxic T lymphocytes, and the immunoregulatory index (IRI, CD4+ / CD8+ T cell ratio) differ significantly by treatment response. Responders have a higher IRI (median 2.1 vs. 1.5 in non-responders, P = 0.04), higher antiplatelet autoantibodies (median 58 vs. 20% in non-responders, P = 0.01) and lower relative CD8+ T cells count (P = 0.02) before treatment.

Discussion: The results suggest that immunological parameters (antiplatelet autoantibodies, relative CD8+ T cell count and IRI) could be used as prognostic tools for a worse clinical outcome in patients with ITP.

Conclusion: These biomarkers could be utilized for stratification and eventually selection of treatment preferring combination therapy.

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淋巴细胞亚群：免疫性血小板减少症患者反应的潜在预测因素。

目的：免疫性血小板减少症（ITP）是一种自身免疫性出血性疾病，由血小板破坏增加和生成改变引起。尽管免疫调节失调的病理生理背景已被充分描述，但目前的治疗指南包括使用不同药物的单一疗法，没有任何工具可以预测哪种治疗方式更适合患者：在我们的研究中，我们试图确定免疫环境的差异，比较患者对治疗的反应。在 12 个月的随访期间，我们对 35 名 ITP 患者（新诊断或复发）的血细胞计数、抗血小板自身抗体和外周血中的 T 淋巴细胞亚群进行了评估：我们的数据显示，抗血小板自身抗体值、细胞毒性 T 淋巴细胞百分比和免疫调节指数（IRI，CD4+/CD8+ T 细胞比率）因治疗反应而有显著差异。治疗前，应答者的 IRI 较高（中位数为 2.1，非应答者为 1.5，P = 0.04），抗血小板自身抗体较高（中位数为 58，非应答者为 20%，P = 0.01），CD8+ T 细胞相对计数较低（P = 0.02）：讨论：结果表明，免疫学参数（抗血小板自身抗体、CD8+ T细胞相对计数和IRI）可作为ITP患者临床预后较差的预后工具：结论：这些生物标志物可用于分层，最终选择联合疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hematology 医学-血液学

CiteScore

2.60

自引率

5.30%

发文量

140

审稿时长

3 months

期刊介绍： Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.