Immune thrombocytopenia is an autoimmune disorder characterized by low circulating platelet count caused by destruction of antibody sensitized platelets in reticuloendothelial system. It can be primary or in association with other disorders. It was recently reported that dysfunctional cellular immunity may play an important role in pathophysiology of ITP.
To study pretreatment and posttreatment cytokine profile of Th1 (IL - 2, IFNy) and Th2 (IL-4, IL-10) T cells in children with acute immune thrombocytopenia.
SETTINGS AND DESIGN
Interventional and observational study.
MATERIALS AND METHODS
A total of 30 patients were evaluated in the study. The tests performed included are complete haemogram including platelet count, peripheral smear examination (P/S), Bone Marrow Aspirate examination (BMA), Serum Anti-platelet Antibody (SAPA) and serum cytokine levels (Th1=IFNγ, IL2 and Th2=IL4, IL10) using ELISA method. To study the sequential changes in serum cytokine levels pre and post treatment with immunomodulatory treatment, CBC including platelet count and serum cytokine levels were analysed on the day 0 i.e pre-treatment and then on day 1, day 4 and day 30 post-treatment. PS, BMA and SAPA were performed only once i.e on day 0.
The results were analysed using paired t-test. The “t” values obtained were used to get the probability (p values) values. “t” Values for various tests were analysed to record the levels of significance. Statistical software used was SPSS version 15.0.
Level of Th1 cytokines i.e IFNγ and IL-2 were found to be high and Th2 cytokines i.e IL-4 and IL-10 were low in all the patients with active disease who have not received treatment. After immunomodulatory treatment, Th1 level got decreased and Th2 levels increased significantly on day 1 after treatment which continued on day 4, 7, 30.
The present study found an increase in Th1 cytokine-IFNy and IL2 and decrease in Th2 cytokine–IL4 and IL10 levels in patients with active disease which get normalised by immunomodulatory treatment.